Hand arthritis is defined by the constriction and inflammation of one or more of the hand's joints. Arthritis causes the loss of articular cartilage, which covers the ends of bones and allows them to move smoothly against one another. When the cartilage is destroyed, the bones scrape together and produce pain during joint mobility. This can result in motion pain, clicking, grinding, and/or loss of grip strength. When arthritis grows severe, the body attempts to support the joint by creating bone spurs or additional bone around the joint's margins. Thumb CMC (carpometacarpal) arthritis is the most prevalent type of hand arthritis, affecting the CMC joint between the thumb bone and the trapezium bone.
Causes
Rheumatoid arthritis and osteoarthritis are the two most common kinds of arthritis. Rheumatoid arthritis develops when the body's immune system promotes joint inflammation. Osteoarthritis develops when the joint surfaces wear down due to misuse, aging, or previous damage. Septic arthritis occurs when an infection in the joint causes cartilage loss.
Symptoms
Hand arthritis patients will feel discomfort, stiffness, and/or loss of function and strength. A grinding, clicking, or locking feeling in the afflicted joint is possible. Loss of mobility can be severe, and the patient may struggle with basic tasks like grasping things and pinch strength.
Treatment
Non-operative
To strengthen the soft tissues that support the joint, physical therapy can help treat thumb CMC (carpometacarpal) arthritis. The stronger the soft tissues that support the joint, the less the body will need to rely on bony architecture to stabilize the joint. Therapy may reduce the strain on the arthritic joint. Because arthritis is characterized by inflammation, your surgeon may recommend anti-inflammatory medicines or an injection to alleviate the inflammation. Nutritional supplements may delay the growth of arthritis in its early stages.
Operative
When non-operative treatment fails or the patient's pain worsens, your surgeon may recommend surgery. Thumb CMC arthritis is surgically treated by removing a piece of the trapezium bone or the complete bone to alleviate symptoms. After the trapezium bone is removed, patients will have a suture device or a ligament in place to keep the thumb hanging in anatomical position. This suspension retains the patient's range of motion and function close to normal by preventing the thumb from moving too far out of normal posture.
Sources
* Shane Anderson A, Loeser RF. Why is osteoarthritis an age-related disease? Best Pract Res Clin Rheumatol. 2010 Feb;24(1):15-26. doi: 10.1016/j.berh.2009.08.006. PMID: 20129196; PMCID: PMC2818253.
* Gillis J, Calder K, Williams J. Review of thumb carpometacarpal arthritis classification, treatment and outcomes. Can J Plast Surg. 2011 Winter;19(4):134-8. doi: 10.1177/229255031101900409. PMID: 23204884; PMCID: PMC3249665.
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