Grip and Bear it: When Thumb Pain Makes it Too Hard to Hold On

When Chicago Bears quarterback Jay Cutler’s season came to an end last year after breaking his thumb bad enough during a game that it required surgery, it vaulted painful thumb injuries into the national spotlight. But dealing with irritating thumb movements is old news for millions who struggle daily with simple tasks such as gripping a door handle or turning a car ignition key. The pain could be pinpointed to a condition known as thumb basilar joint arthritis.

The basal joint refers to the pivot point at the base of the thumb where pinching and rotation movements originate. Painful flare-ups can occur because of normal wear and tear over years of routine thumb pivoting. Thumb basilar joint arthritis is also known as thumb CMC arthritis because it impacts to the thumb’s carpometacarpal joint or (CMC).

“Thumb basilar joint arthritis is a very common problem and we see a fair amount of it in the hand surgery world,” said Dr. Marcus Talerico, MD an orthopedic hand surgeon with the MidAmerica Hand to Shoulder Clinic in Libertyville. “It’s actually more common in women than in men and many patients can be predisposed to the condition, even if they don’t have a history of arthritis. In fact, the etiology of this problem is likely multifactorial, with genetics and perhaps overuse contributing significantly.”

Treatments vary depending on the level of pain or joint deterioration. As thumb basilar joint arthritis progresses, thumb movements not only can become more painful, but weaker as well. When cartilage around the thumb basal joint wears away, joint deterioration becomes more pronounced with bones rubbing against each other. For some patients, icing down the thumb, wearing a splint supporting the thumb and wrist and taking a non-steroidal anti inflammatory medication (NSAID) such as aspirin or ibuprofen may be enough. For others, surgery may be a better option.

Total reconstruction of the thumb’s basilar joint is a widely used surgical procedure for alleviating the pain. It involves removing what’s called the trapezium bone, which sits at the base of the thumb. Tendon grafts then may be used to connect bones around the trapezium in order to preserve the thumb’s shape and position. Hand surgeons may also use what’s called a tendon interposition to create the same result – rearranging your body’s own hand tendon tissues to eliminate joint pain in the thumb. Finally, a hand surgeon creates a virtual cushion pad constructed of tendon grafts to take the place of the trapezium and act as pillow of tissue that now serves at the thumb’s base.

“Instead of arthritic bones rubbing against each other at the base of the thumb, the cushion made of your own body’s tissues softens the movements,” added Dr. Talerico. “After about three months of recovery and possibly some physical therapy to build up dexterity, patients may enjoy full range of motion with their thumb again, pain free.”

Thumb pain is different in each patient and it’s important to consult a specialist to determine the level of movement difficulty and a proper course of treatment – which may or may not involve surgery.  To learn more about thumb basilar joint arthritis and the MidAmerica Hand to Shoulder Clinic of Libertyville, please visit www.handtoshoulderclinic.com or call 1-855-4MY-ORTHO (1-855-469-6784).