Question: 

What are the treatments for arthritis in the thumb joint? Is joint replacement recommended? 

Answer from Nebraska Medicine orthopaedic surgeon Daniel Firestone, MD: 

The thumb is one of the hardest-working joints in the body. Thumb arthritis is one of the most common types of arthritis we see in the hand. It happens when the cartilage at the base of the thumb wears down over time, causing the bones to rub against each other. It’s especially common in women over age 50, but it can affect anyone as they get older.

For most people, thumb arthritis is simply the result of wear and tear over time. We put a lot of mileage on our thumbs throughout our lives. Every time you pinch, grip or hold something, you’re using that joint. Decades of use can eventually wear down the cartilage and lead to arthritis. Previous injuries, genetics and joint laxity can also increase the risk.

Diagnosis usually starts with a physical exam and discussion of symptoms. We look for tenderness, swelling and reduced motion in the joint. X-rays can help confirm the diagnosis and show how much the arthritis is present. 

The best treatment depends on the severity of the arthritis and how much it affects daily life. Most patients start with conservative treatments such as splinting, anti-inflammatory medications, activity modification and hand therapy. Many people can manage symptoms without surgery.

Braces can be very effective, particularly for mild to moderate arthritis. They help support the joint, reduce painful motion and allow the thumb to rest during activities that may cause discomfort.

Hand therapy can improve strength, flexibility and function while reducing stress on the joint. A therapist can also teach patients ways to perform daily activities that place less stress on the thumb. 

Steroid injections may be recommended when pain isn’t adequately controlled with other treatments. They can reduce inflammation and provide temporary relief that lasts anywhere from a few weeks to several months. 

We typically discuss surgery if pain continues to interfere with daily activities after non-surgical treatments. If someone can’t perform tasks they enjoy or need to do every day, surgery might be worth considering. 

Several surgical procedures can treat thumb arthritis. The most common involve removing the arthritic bone and reconstructing the joint to relieve pain while preserving function. The right procedure depends on the patient’s age, activity level and severity of arthritis.

Thumb arthritis surgery has a high success rate. Most patients see significant pain relief and improved hand function. There are a variety of effective treatment options that can reduce pain, improve function and help people get back to doing the things they enjoy.