What are recommended exercises for thumb arthritis?

Doing hand stretching and strengthening exercises can help keep your thumb flexible and the joints stable. Often in thumb OA, the tissue between your thumb and index finger feels very tight. You can reduce tightness and improve thumb flexibility by utilizing heat therapy, following the massage techniques, and gently stretching the thumb in order to maintain or improve mobility. Also, strengthening the muscles that surround the thumb can help enhance the stability of your CMC joint.

Recommended exercises for thumb arthritis:

“Place and Hold”: Touch the tip of your thumb to the tip of your index finger so that they form a circle. Now, balance the middle joint of the thumb using the opposite hand so that your thumb joint is marginally bent. Pinch the fingertips jointly and remove the supporting hand while maintaining the circle position. Gradually, increase the force of the pinch until it feels like the circle will collapse and the thumb will lose its bent position, and then relax your fingers. Do this ten times.

Radial abduction stretch: Rest your hand on a table, palm down. Spread your thumb away from the hand, opening your palm wide. Hold for five to ten seconds, and then return to the starting position. Repeat for a total of 10 stretches.

“C” exercise: Place your thumb and fingers in the shape of the letter C as if you are holding the tennis ball. Cling to this position by tensing the muscles lightly, for five to ten seconds before relaxing. Repeat this for ten repetitions. You can make this exercise more challenging by applying a rubber band around your thumb and fingers while holding the “C” position.

Will massage therapy be effective for CMC arthritis?

When the muscles around the thumb tightens or stiffens, a self-massage is a good way to relieve it. You can massage yourself by simply rubbing the area around the thumb. You may use a golf ball or a tennis ball and roll them over on a table. A vacant roll-on deodorant bottle can also be used.

Interlock the hands at the area between the thumb and the index finger and then, push the hands against each other. Thus, both hands will get stretched and are also massaged gently when at the same time not getting a lot of stress on the thumbs.

Can heat and/or cold therapy help with CMC arthritis?

Applying heat or cold to the thumb can help relieve Osteoarthritis (OA) pain. Both ice and cold pack can be helpful in decreasing the level of inflammation, muscle spasm, and/or pain. However, cold treatment does contribute to stiffness, so it is best not to use it before doing hand exercises. You can buy reusable cold packs and keep them in the freezer, or you can make your own cold pack with a bag of frozen vegetables or a plastic bag filled with ice. Place a towel between the ice pack and your skin, and apply the pack for at least 10 to 15 minutes at a time.

Many people prefer the soothing sensation of heat therapy over cold therapy. Heat therapy can help reduce pain, decrease stiffness and muscle tension, and relieve muscle spasms. You may find it helpful to use heat therapy before doing activities which will need a lot of mobility in your thumb, such as playing the piano.

One can put in the heat on the hand with the help of a hot pack, heating pad, or a paraffin bath. One can also get a hot pack loaded with gel or flaxseeds, heat it in the microwave, and apply it to your hand. Alternately, you can create your own pack by filling a sock with some uncooked rice and tying off the ends. Before using, microwave the sock for one minute and shake to distribute the heat. You can rest your hand on the sock or wrap the sock around your hand. An electric heating pad can also be helpful. With any hot pack or heating pad, place a towel between your skin and the heat source, and apply the heat for up to 20 minutes at a time.

Another compelling way to put apply heat to your hand is a paraffin bath. These are small tubs in which you can heat paraffin wax and mineral oil mixture. You need to let in your hand into the wax multiple times to get layers of wax. Then, keep the hand in a plastic cover and wrap it with a towel to keep the heat.

How can I protect my CMC joint?

Altering the way you use the thumb can be an important strategy because it decreases the pressure that is exerted on the CMC joint and avoids further injury. Begin by figuring out the activities that create pain, and then find out the ways to alter the way you do those activities.

Following are some tips to protect the thumb joint during some common tasks:

  • While trying to lift a heavy plate or tray, keep your palms below it instead of gripping the sides.
  • Avoid pinching books using your thumbs. Also, always hold the books with one of your palms flat below the book’s center and the other on the top in order to balance it properly.
  • Expand the handle of your knife and other tools because larger handles will be easier to grasp.
  • When you cut using a knife, grasp it using both hands for extra strength.
  • When you stir, avoid pinching the spoon using the thumb. Rather, try holding it using your palm along with the fingers covering the handle.
  • Grasp the toothbrush or hairbrush using your fingers by keeping the thumb alongside fingers.
  • Lubricate those locks that are hard to turn.
  • Rope keys to the key holder to let you turn them using your palm instead of the thumb.
  • Utilize non slip rubbers or silicone mats for opening jars or bottles.
  • Choose those garden tools that will help ease your thumb pain.
  • For cutting with scissors, use those which are spring-loaded.
  • While writing, use modified pens like Pen-Again with a distinctive grip that will place most of the pressure on the forefinger instead of your thumb.
  • Utilize electric appliances electric can openers, electric toothbrushes, or electric screwdrivers.
  • Make use of adaptive gadgets, such as bottle openers, pull-tab grabbers, and so on for opening containers and packages.
  • Use shampoos and lotions that are available in bottles with dispensers rather than that require squeezing.

What is CMC Joint Fusion?

Joint fusion is a surgical procedure that is done to fuse the surfaces of your thumb metacarpal with the trapezium bone so as to prevent them from moving and causing pain. This is usually carried out on younger patients who require more thumb strength to do their jobs (for example, carpenters).

Once this fusion is done, the pain will go away. Although it will loosen the joint movement, they would still give the capability to grasp and pinch. It’s to be noted that the joint fusion will be prescribed only when all other forms of treatments, including the joint replacement, haven’t worked.

During the operation:

This surgery can prolong to up to 90 minutes. It may be done under a general anesthetic or a local anesthetic. Once you get the anesthesia, the surgeon will ensure that the skin in your hand is free from infections by cleaning it with a germ-killer.

A cut will be made on the side of your thumb just above your CMC joint. The joint capsule that surrounds the CMC joint will then be opened so as to make the joint surfaces visible. Then, the articular cartilage will be removed. A tool will be used to void the end of your thumb metacarpal so as to create a socket. Then, the surface of your trapezium will be made into a rounded cone in such a way that it fits into the created socket.

The surgeon will keep a metal pin along the center of both the bones to connect the cone and socket comfy together. The soft tissues above the joint will then be fused back together. Once this is done, the forearm and hand will be placed in a cast until these bones completely join together. It will take about six weeks for this to happen.

What does arthritis of the thumb feel like?

Stiffness and pain in hand:

The initial sign of arthritis is pain, stiffness, and tenderness. As you try to grip, pinch or clasp, you will feel the tenderness or pain in the base of your thumb. Simple things like turning the doorknob, twisting the key, etc. can cause lingering pain. However, severe pain doesn't mean that arthritis is also severe.

Weakness and decreased range of motion:

Because of the pain, eventually, the joints may weaken and lose their range of motion. It will worsen when you do actions like pinching or clasping something. Basic activities like opening a bottle, holding something, buttoning up, etc., will become difficult. In case of severe arthritis, the tasks that were simple earlier will be difficult or impossible without assistance.

How can Thumb Splints help with thumb arthritis?

A splint can provide relief by resting the arthritic joint and cooling down the inflammation associated. While performing any activity that may worsen the symptoms, it is advised to wear a splint. The simplest one is the "thumb abduction splint." But in case of severe symptoms, a thumb brace may be needed. This is more supportive of the thumb, but not very convenient while doing your daily chores.

These splints can help with:

  • Reducing pain
  • Resting the joint
  • Properly positioning the joint while performing tasks

Who is at risk of contracting thumb arthritis?

The risk factors associated with arthritis of the thumb include:

  • Age: Degenerative thumb osteoarthritis can develop in people of all ages. However, it is found to be very rare in the people aged 40 and below. As this is a gradually developing condition, the risk of contracting thumb arthritis can be considered to be increasing with age.
  • Gender: Degenerative thumb osteoarthritis, as well as rheumatoid arthritis, is more likely to occur in women than men. On the other hand, men are at high risk of getting gouty arthritis.
  • Athletics: People who suffer a thumb joint injury during a rough and high-impact sport are at an increased risk of getting post-traumatic thumb arthritis. Example of such sports include:
    • Football
    • Basketball
    • Soccer
    • Wrestling
    • Rugby
    • Hockey
    • Skiing
    • Snowboarding
  • Familial history: Certain arthritic conditions like rheumatoid arthritis can be from genetics. The individuals, who have an immediate family member or any relative carrying a history of rheumatoid arthritis, are at a high risk.
  • Smoking: Several studies have suggested that smoking is among the key factors for rheumatoid arthritis.
  • Certain occupations: People with certain occupations like painting that need a group of repetitive movements for extended periods are said to be at high risk of contracting degenerative thumb osteoarthritis.

Now, it’s important to understand that posing a risk factor doesn’t mean that you will definitely get the condition. A risk factor simply increases the chances of contracting a condition when compared to the individuals without them.

On the other hand, not posing a risk factor doesn’t mean that the individual won’t contract the condition at all.

Can you get arthritis from texting?

While it’s not easy to point out one distinct underlying cause of arthritis, researchers strongly believe that the rapidly increasing duration that we spend on our mobile phones and other similar gadgets could lead to a larger incidence of those medical conditions that we have been dealing with in the past. Even if there are no signs of arthritis initially, excessive texting and scrolling could add up over time and result in hand and wrist pain at the later part of life.

In addition to causing strain on our hands and fingers, hunching over the mobile phone or tablet can also cause back and neck pain because of poor posture. In order to prevent this, remember to sit erect with your feet placed on the floor, and keep your phone or gadget directly before you. This will keep you from craning the neck downward for seeing it.

“Texting Thumb”:

The main issue with texting on your mobile phone is that the repeated movements using your hands, as well as fingers, could damage and cause injury to your joints, surrounding muscles, as well as tendons due to overuse. This could result in a condition called “texting thumb,” which is a repetitive strain injury. Even though a diagnosis of texting thumb does not necessarily mean that you would get arthritis or carpal tunnel in the later part of life, you must remember that it’s just as uncomfortable, as well as painful as these conditions.

If you begin to experience ache and pain in your hand, wrist, or finger while using a mobile phone or any other device, all you need to do is to take a break. Rise up and do stretches and walk around to help decrease the symptoms of texting thumb.

How can I slow down CMC arthritis naturally?

There are a few things that you can do to slow down your CMC arthritis naturally. They are:

  • Keep moving: Try not to hold one position for a long duration. While working at your desks, for example, move up from your seat and stretch every now and then. This is also applicable while sitting at home as well.
  • Identify your strength: Engage your most robust joints and muscles. To save your fingers and wrist joints, push open those heavy doors using the sides of your arms and shoulders. To decrease the hip or knee pressure on the stairs, put the strong leg up and the weak leg down.
  • Plan ahead: Try to simplify and organize your daily chores to decrease movements that are hard and painful. Only do the necessity daily  activities, such as cooking, cleaning, and hobbies.
  • Use devices and adaptive aids: There are several simple gadgets and devices to make your life easier. They would help you to perform almost all the daily activities, such as cooking, gardening, and getting dressed. For example, long-handled grippers will help grip and retrieve those objects in your shelves. There are rubber grips to help you have a better grip on faucets and silverware. Likewise, there are a variety of aids to help people with arthritis.
  • Ask for help: Patients with arthritis are more likely to worry about becoming dependent on their family and friends. However, remember that only a small ratio of people with the condition becomes seriously disabled. But still, the emotional burden of dealing with arthritis is significant. Make your family members and friends understand how arthritis has affected you, and don't hesitate to ask for help whenever you need.

What not to eat when you have arthritis?

Fried and/or processed foods:

Reduce the amount of fried and/or processed foods you take. These include fried meats, prepared frozen meals and so on. Instead, add more vegetables and fruits to your everyday meal.

Lower the Advanced Glycation End products:

To reduce your blood AGE levels, it is recommended that you cut down on foods that are cooked at very high temperatures.

Sugars and refined carbohydrates:

Cut down on the candies, processed foods, baked items, as well as sodas to decrease your arthritis pain.

Dairy products:

Instead of getting protein from dairy, try to get it from sources like:

  • Spinach
  • Nut butters
  • Tofu
  • Beans
  • Lentils
  • Quinoa

Alcohol and tobacco:

For your joints to be healthy, you need a balanced diet, an adequate amount of physical activity, and sufficient rest. All these can be compromised by the use of alcohol and tobacco. Therefore, it is advised that you cut down on drinking and smoking.

Salt and preservatives:

Make sure to read labels and avoid those with preservatives and additives. Cut down on the amount of salt to help you manage arthritis.

Corn oil:

Substitute the foods that contain omega-6 fatty acids with healthy alternatives like omega-3, which are found in:

  • Olive oil
  • Nuts
  • Flax seeds
  • Pumpkin seeds

Can CMC arthritis spread quickly?

According to a new study, the cells around the joint that is affected by rheumatoid arthritis may travel through blood vessels and spread the disease to the other joints as well. Researchers say that the disease initially starts in some joints and spreads to other places quickly.

Can CMC arthritis move around your body?

Pain that you feel in a particular joint can make you suspect arthritis or some other health condition. If this pain ceases and if you see there is a movement of pain to another joint in any part of the body, then you might be suffering from migratory arthritis.

Why am I having pain only in the thumb?

If you are experiencing pain only in your thumb, you might be suffering from any of the following conditions:

  • CMC Thumb Arthritis: You might be having CMC thumb arthritis if it pains at the base of your thumb (the point where the thumb meets the wrist). In the case of CMC thumb arthritis, you may also feel pain while pinching and/or gripping, particularly when you hold tiny objects.
  • de Quervain’s Tenosynovitis: You might have this condition if it pains along the sides of your thumb while moving it into your hitchhiker position. If you have this condition, you might also feel pain while bending the hand towards the little finger. In addition, the pain will shoot up in the forearm along the side of the thumb.
  • Gamekeeper’s or Skier’s Thumb: You might have this if it hurts for you in the middle joint of the thumb at the point where it joins to the hand. Moreover, you will also have difficulty gripping and holding objects. Furthermore, you may find it painful and hard to pinch.
  • Trigger Thumb: You might be having a trigger thumb if there is “popping” pain while bending and/or straightening the tip of the thumb. In this case, the thumb will stick in a bent position, and you need to pull it to become straight.

How is CMC arthritis treated?

Even though thumb arthritis can be paralyzing, many non-surgical treatments can help ease pain and restore functionality. Icing the painful joint for at least five to 15 minutes multiple times a day can be helpful. The other treatments you can try by yourself include medications like acetaminophen, NSAIDs, heat pack, paraffin bath, and topical cream.

Splinting can also provide you with pain relief to a certain extent. You can use a soft splint to stabilize your thumb, as required during the daytime. You can also use hard plastic splints to help increase functionality and to alleviate pain.

If splints don’t give you pain relief even after a few months of use, the next stage of treatment generally involves steroid injections, which will be administered directly into the painful joint. In most cases, these injections will give you lasting relief.

When all the above nonsurgical treatments are no longer working, and if your pain is severe, surgery is the next option.

The most commonly prescribed surgery is “ligament reconstruction and tendon interposition (LRTI).” This is considered to be the gold standard for the surgeries for basal joint arthritis.

This involves removal of your trapezium and replacing with a tendon substitute that will be taken from your forearm in order to stabilize your thumb. The surgery will be done on an outpatient basis. After surgery, the patient will be required to use a splint or a cast for up to six weeks.

How should I prepare for thumb surgery?

When the surgery is decided, the doctor and his staff will plan the procedure at the hospital. To ensure if the patient is fit for surgery, blood tests and other diagnostic tests are performed. In case, if you have multiple and severe medical conditions, you will be advised to visit your general physician before the surgery.

The night before the surgery, you will be instructed not to eat anything. Seven days prior to the surgery, anti-inflammatory medications like ibuprofen and aspirin should be stopped. Discontinuation of blood thinning medications, such as Coumadin or Plavix is also preferred. Additionally, medications for rheumatoid arthritis also need to be stopped. You will be instructed by the surgeon based on your medication list, and you must follow accordingly.

What's involved in CMC surgery?

Surgery may be required if medicines, exercising, and splinting do not alleviate the pain and bring back the range of motion. Some of the possible surgeries for thumb arthritis are.

Trapeziectomy: One of the wrist bones that are involved in your thumb joint will be removed.

Osteotomy: The bones of your joint will be moved and aligned rightly. In addition, they may also be trimmed to ward off excess growth.

Joint fusion: As the name suggests, the bones in your joint will be fused to improve stability and reduce pain. But, there will be no flexibility in your joint.

Joint replacement: As it sounds obvious, the joint will be substituted with tendon grafts.

What to Expect at Surgery?

Arrive at the hospital or surgery center at least 1-2 hours in advance to your surgery appointment.

This helps the staff in getting to know you better, get the formalities done and you will also be mentally prepared for the surgery. You will meet a preoperative nurse who will get you dressed for surgery. The anesthesiologist will provide you with various options available to help you sleep comfortably and pain-free during the procedure. The nurse and scrub technician will assist the surgeon during the surgery.

After the surgery, a postoperative nurse will help you recover from the anesthesia. The nature of anesthesia you were given will decide the time you will spend in postoperative care area. The time taken for discharge is unpredictable and can take long hours. This does not signify any emergencies.

What type of joint is the CMC joint?

Five carpometacarpal joints are present in each hand. The first CMC joint or joint of the thumb is in the shape of a saddle and the rest four are synovial elliptical joints.

The articulation happens between the carpus and metacarpal bones, which are second to fifth.

The carpometacarpal joint also called trapeziometacarpal joint plays an important role in the normal activity of the thumb. It must be acknowledged that most of the human hand activity depends on the movements of the thumb and index finger. Thus, it can be said that this joint is very crucial for the functioning of the hand.

The three distinct ligaments, namely, lateral, anterior (Palmar), and posterior (Dorsal) hold the joints in place.

Lateral Ligament: It runs between the lateral side of the trapezium and the radial side of the metacarpal base.

Anterior and Posterior Ligaments: These are oblique bands that converge to the ulnar side of the metacarpal base.

In addition, we can also find a strong fibrous capsule that is known to add stability to this joint.

What is CMC OA?

Thumb CMC OA is a commonly occurring disease. Between 11% and 33% of males and females during their 50s and 60s are affected by this. This causes pain, laxity, and weakness in the CMC joint.

The carpometacarpal (CMC) joint is found at the base of the thumb, the point where the thumb is attached to the hand. Like arthritis in other parts of the body, the pain starts with the wearing out  of the cartilage, and when the bones start colliding against each other.

CMC OA is more common in women than men just like the knee and hip OA. Up to 80 percent of women are affected by this condition by the time they are 80. This disrupts everyday chores in the kitchen , chores around the house, or people who work using computers, doing assembly work, or using power tools.

Is thumb surgery painful?

Thumb arthroplasty is prescribed in individuals suffering from advanced basilar thumb arthritis. The aim of the procedure is to reduce the pain in the thumb and to improve its functioning. Activities like pinching or grabbing can cause severe pain in the patient’s thumb.

During the procedure, the joint is removed and reconstructed using a tendon. The patient will be given general anesthesia along with an auxiliary block. The block will be discussed with the patient by the anesthesiologist.

The patient will experience no pain when he wakes up from surgery. The effect of the anesthesia will continue to last for several hours after the surgery. For the surgery, an incision is made along the border of the thumb. The entire bone in the joint is taken out, and a tendon graft is used to replace it. One or two incisions are made in the forearm to obtain the tendons. The tendon so obtained is redundant, and its absence will not be noticed. The thumb is stabilized using pins which will be removed in 4 weeks.

Normally, the procedure provides relief for most people. After recovery, the pain is completely gone, and your range of motion will be normal.

In most cases, once you have recovered, the pain will be gone, and you will have relatively normal motion. However, pinch strength may not improve. Any surgery comes with risks, and as far as thumb arthroplasty is concerned, the risks might involve an infection after the surgery, numbness on the top of the thumb, and stiffness.

What is the first CMC joint?

The CMC or carpometacarpal joints are the set of five joints in our wrist whose primary function is articulating the distal row of our carpal bones, as well as the proximal bases of metacarpal bones.

This CMC joint of our thumb (i.e., the first CMC joint called trapeziometacarpal or TMC joint), differs greatly from the other CMC joints. This joint got its name, “trapeziometacarpal joint” since it links the trapezium to the 1st metacarpal bone, thereby playing a remarkable part in the normal functioning of our thumb. Osteoarthritis of this TMC joint is a seriously disabling condition and is also more common among elderly women.

Pronation-supination of this first metacarpal is very significant for the movement of opposition. The movements of the 1st CMC are restricted due to several factors like:

  • The shape of its joint
  • Capsuloligamentous complex that surrounds the joint
  • Balance among the muscles involved

If the first metacarpal is unsuccessful in sitting sit well 'on the saddle' due to conditions like hypoplasia, the TMC joint will tend to become subluxated or lightly displaced towards the radius.

Can thumb arthritis be cured?

There is no cure for thumb arthritis. However, there are many treatments that are simple and have provided relief for many people. It is better to talk to your doctor or physical therapist about the treatment that will work best for you.

Treatment options:

For each individual, arthritis is different. For any particular symptom, there are numerous treatments that may work.

The primary level treatments involve:

  • Exercises
  • Ice
  • Medications
  • Splints
  • Steroid injections

In case the above methods do not provide relief from pain or do not improve the functioning of the thumb, reconstruction of the joint may need to be done using surgery.

Just like any form of arthritis, always talk to your doctor before beginning to treat your condition or taking any medications.

What causes CMC joint pain?

A common cause of thumb arthritis is aging. Trauma or injury that was caused previously to the thumb joint can also lead to thumb arthritis.

The cartilage acts a cushion and covers the tip of the bones. This permits the bones to move smoothly against each other. The deterioration of the cartilage that covers the tip of the bones is called thumb arthritis. Eventually, the smooth surface gets rough. The bones then collide against each other, and this results in friction and damaging of the joints.

This damage may also lead to the growth of a new bone beside the existing ones. This is known as bone spurs, which can cause apparent lumps on your thumb.

How long does it take to recover from thumb joint surgery?

There are different recovery approaches, and every surgeon follows their own method. In order to avoid excessive swelling, it is necessary to keep the hand elevated for at least two days. While walking, do not leave your hand dangling at the sides, and do not rest it on your lap while you are seated.

The time taken to recover can differ from person to person. Two to four weeks after the surgery, the dressing or the cast will be changed to a light plastic splint. Watch out for infections or red patches. This plastic splint can be removed so you can exercise easily. It is also washable, however, pay attention to the advice given for the specific therapy.

After around 5-10 days of the surgery, a “wound review appointment” will be given to you. You will also be given a splint made for your hand which can be removed during the day after four to six weeks of the operation. However, it must be used during the night for two more weeks.

At this moment, physiotherapy can begin. This will help restore your complete range of movement. Stop immediately if any exercise causes pain.

How do you know if you have arthritis in your thumb?

The most common and the earliest symptom of arthritis in the thumb is pain. When you try to grip or grasp an object or pinch something, you will experience pain at the base of the thumb. It will hurt when you apply force using your thumb.

However, there are other symptoms or signs like,

  • The base of the thumb will get swollen, and you will experience stiffness and tenderness
  • When you try to pinch or grab an object, the thumb will feel weak
  • The range of motion of the thumb will be very slow
  • The joint at the base of the thumb will either be enlarged or look bony