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Pain in the thumb

Do you experience pain in the base of your thumb?

You may have what is called osteoarthritis (OA) of the carpometacarpal (CMC) joint of the thumb. This can be common, particularly as we move across the lifespan. If untreated, can be extremely debilitating, restricting ability to perform day to day activities.

Symptoms

Symptoms may include pain with writing, using a phone, pinching, trying to open small packets, jars, using pegs to hang out washing, difficulty grasping or gripping objects in the kitchen, garden or gym.

In many instances, people may also experience aching in the hand, even when at rest, feelings of stiffness and general weakness in the hand, particularly in cooler weather.

Anatomically the carpometacarpal (CMC) joint of the thumb favours motion over stability, which is crucial to allow us to hold and manipulate objects. However this also lends the joint biomechanically to articular wear. Over the lifespan, the joint at the base of the thumb is subject to a considerable amount of force through daily activities and therefore the cartilage between the bones deteriorates or wears down over time. This can lead to pain, weakness and difficulty carrying out day to day tasks.

Treatment

Hand Therapists are skilled in evaluating and treating conditions of the hand and can provide an individualised assessment of the thumb. They can determine the best course of treatment, which may include use of thermal modalities (heat packs, specialised gloves), soft tissue release, activity modification and splinting.

Goals will almost always prioritise protection of the thumb joint(s) moving forward, offering techniques to alleviate or manage pain, improve mobility, strength and facilitate return to desired activities.

An example of splints and gloves are pictured below; however many other options are available. It is recommended that you receive an individualised assessment and treatment plan, should you experience any of the above mentioned symptoms.

– Kate

References:

Buhler, M., Chapple, C. M., Stebbings, S., Sangelaji, B., & Baxter, G. D. (2019). Effectiveness of splinting for pain and function in people with thumb carpometacarpal osteoarthritis: a systematic review with meta-analysis. Osteoarthritis and Cartilage, 27(4), 547–559. 

Gillis, J., Calder, K., & Williams, J. (2011). Review of thumb carpometacarpal arthritis classification, treatment and outcomes. The Canadian Journal of Plastic Surgery = Journal Canadien de Chirurgie Plastique, 19(4), 134–138. 

Poole J. & Pellegrini V. (2000). Arthritis of the thumb basal joint complex.  Journal of Hand Therapy. 13(2), 91–107.

Skirven, T., Osterman, A., Fedorczyk, J., Amadio, P., Feldscher, S. & Eoan Kyu Shin. (2021). Rehabilitation of the Hand and Upper Extremity (7th ed. Vol. 2). Philadelphia, PA: Elsevier Mosby.

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