Arthritis in the Hand

It very commonly affects the joint at the base of the thumb called the 1st Carpometacarpal joint (CMC). Disability associated with arthritis in this joint is usually pain rather than decreased range of movement or strength. Pain is felt at the base of the thumb with pinching tasks such as turning a key, opening a jar, turning on/off taps or holding a book. In the later stages the joint develops a ‘square’appearance and may be associated with swelling. The second joint in the thumb (MCP) develops a secondary deformity and collapse toward the palm reducing the ability of the thumb to extend fully away from the pain.

Typically this affects women from the 4th decade and may be associated with other small joint arthritis around the time of menopause. The non-dominant thumb is usually affected first.

Your Hand Therapist will assess the stage of deterioration of the joint by viewing x-rays and performing clinical tests. You will be given information on joint protection techniques and small aids and appliances that can be used for everyday tasks that will reduce the wear and tear on the joint thereby minimising pain.

One of the most important aspects of treatment for this condition is the fabrication of a custom thermoplastic splint that will reduce the subluxation in the affected joint thereby assisting the joint to be more stable and pain free during use. Whilst nothing can change the deterioration that has already taken place, splinting and activity modification can minimize future wear and tear on the joint. Almost always those with this type of arthritis will gain excellent pain relief from splinting during activity. Should these conservative measures fail to give relief your Hand Therapist at The Sports Injury Clinic will refer you back to your GP to arrange referral to a plastic and reconstructive surgeon to discuss surgical options.