The thumb, with its unique ability to touch the other fingers, is hardly noticed by us until we have some sort of problem with it. That’s when we become aware of its versatility and usefulness. One of the common complaints of the thumb is carpometacarpal joint pain. To put it in layman’s terms, it is arthritis of the thumb joint. It causes pain at the base of the thumb when you pinch or grip something. The joint at the base of the thumb allows for it to be swiveled and pivoted and it is called the basal joint, or the carpometacarpal joint. This type of arthritis of the thumb joint, is common with those who are prone to osteoarthritis. This problem can afflict almost anyone; however, the degree of pain and response to treatment varies.
The basal joint, due to its constant usage, is particularly prone to wear. This causes the basal joint to get arthritic, causing pain, swelling and tenderness. In some people it is just a trivial pain and they ignore it. However, in others, the pain is from moderate to severe and would require medical attention and, in extreme cases, even surgery.
If the pain is mild, you can simply apply ice it for about 15 minutes to provide sufficient relief. There are many over the counter non-steroidal anti inflammatory medications available, such as ibuprofen, aspirin etc. However, it is advisable to be cautious, as there may be possible side effects. You could also wear a brace which supports the wrist and thumb. Physiotherapy can also be of help. If none of these help in easing the pain, then it is time to seek medical help.
The doctor, with his expertise, has many more options for treatment of the pain. Once the doctor has confirmed that the problem is actually caused by carpometacarpal joint pain, he may prescribe a stronger medicine. He could prescribe hand therapy or make you wear a custom prescription splint. He may give a cortisone injection to the joint. As a last option he may prescribe reconstructive surgery.
There are many different types of operations for relieving carpometacarpal joint pain. The most common operation involves total reconstruction. This is a three stage process involving different bones of the thumb and wrist, tendons and steel pins etc. Recovery usually takes about three months. The wrist and thumb will have to be kept in splints for about 4 to 6 weeks. Then, exercises have to be done to improve the strength and flexibility, and it is generally done under supervision. It is advisable to go easy on the wrist for a couple of months until it regains its full strength.
The patient’s response to treatment is varied. For some, the ice and OTC medication are enough. For others, the cortisone shot does the trick, if not permanently, it lasts for quite some time. Most of those who underwent surgery get relief, but about 20% will develop a new symptom such as numbness, tenderness, no improvement in pinch strength, reduced flexibility of thumb movement, etc.
Carpometacarpal joint pain, can be ignored if it does not decrease the quality of life. For those who cannot ignore it, it is better to seek attention at an early stage. At an advanced stage, treatment and cure can be very difficult, if not impossible and the damage may be irreversible.