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Thumb Basal Joint Arthritis

September 17, 2015 by Greg Balourdas

Our ability to pinch and grasp is easy to take for granted.  I came accross this great quote in science fiction writer, Isaac Asimov’s Foundation series recently and have to share it.  Who would have thought someone other than a hand specialist would understand the hand so well?!

“Why not the hands?

The eyes were no more than sense organs, the brain was no more than a central switchboard, incased in bone and removed from the working surface of the body.  It was the hands that were the working surface, the hands that felt and manipulated the universe.  Human beings thought with their hands.  It was the hands that were the answer of curiosity that felt and pinched and turned, lifted and hefted.  There are animals that had brains of respectable size but it was the hands that made all the difference.”

Isaac Asimov, Foundation’s Edge c1982

And what is the most crucial part of the hand and the most devastating if lost?  You guessed it: the thumb.  Loss of use of the thumb due to pain, weakness or loss of motion from injury or arthritis has a profound affect on daily life.

Arthritis of the base of the thumb goes by other names: Thumb basal joint arthritis and CMC (carpometacarpal) arthritis.  Arthritis is progressive and can cause pain, weakness and stiffness and impact daily activities including opening jars, turning doorknobs or keys, using a computer mouse, and writing.

CMC OAArthritis of the Basal Joint of the thumb.

Other conditions and injuries can cause similar symptoms and difficulties.  There are many important structures that can be affected that affect the area.  Tendons (DeQuervain’s tendinitis), nerves (radial and median), as well as other ligaments and bones which are in the vicinity of the thumb basal joint.

An accurate diagnosis of Thumb Basal Joint Arthritis is made by examination by a specialist, x-ray and sometimes other studies to be certain other diagnoses are not at play.

Treatment options for thumb arthritis begin with assisting in the managment of pain and improving motion and function with ice, heat, anti-inflammatory medicines, splinting and adaptive aids.  Treatment is commonly provided by a skilled hand therapist.  Further treatment by your hand specialist includes injections and surgery.

splint cmc oa


Splint created by a Hand Therapist

Joint replacement surgery, (similar to joint replacement of the knee or hip), is the most common procedure for arthritis of the hand or arm.  This procedure has a 30 plus year history for effectively stopping arthritis, providing pain relief and improved pinch.

pop cmc lrtiX-ray after joint replacement surgery

Some informative links to more information on the subject:  My office website,  American Academy of Orthopedic Surgery, American Association of Hand Surgery, and Dr. Eaton’s website.

Greg Balourdas, MD


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