Thumb arthritis

Arthritis at the base of the thumb is very common, especially in ladies after the menopause. However, despite lots of people having the signs of thumb arthritis, many actually don’t fell much pain; and if that is the case no treatment is needed. Often the thumb starts to be pulled in towards the palm by the arthritis, and the next joint along can become stretched out to compensate.

If this happens and the patient is in pain, Mr Wharton tries novel splinting techniques (Jura and Push) to try to support the position of the thumb. Patients often find these very comfortable and many will avoid further treatment for several years. When the pain flares Mr Wharton offers steroid injections in clinic to help with the pain. These can sometimes irritate the arthritis for a few days, and regular simple painkillers should be taken for a few days afterwards.

When injections have stopped helping with the pain, Mr Wharton offers an array of different surgeries for thumb base arthritis, including a fusion of the carpo-metacarpal joint, trapeziectomy with ligament reconstruction, and thumb CMC joint replacement. These procedures are all very affective at treating pain, and are all conducted as a day case under general or regional (nerve block around the shoulder) anaesthetic. Afterwards regular painkillers are sometimes needed for several weeks, and it is important to elevate the hand for five days, and keep the wound dry for two weeks. Often a plaster cast is applied in the operating theatre for two weeks, and a splint is made for four weeks after that.