Thumb-Base Osteoarthritis Injection Therapy

What Is Thumb-Base Osteoarthritis?

Thumb-base osteoarthritis affects the carpometacarpal joint, commonly called the CMC joint, where the thumb meets the wrist.

This small joint plays an important role in gripping, pinching and positioning the thumb. Osteoarthritis can develop when the smooth joint surfaces change and the joint becomes irritated, painful or less stable.

Symptoms commonly include pain at the base of the thumb when opening jars, turning keys, writing, using scissors, holding a phone or gripping heavier objects. Some people notice stiffness, reduced pinch strength, swelling or a change in the shape of the thumb base.

The severity of changes seen on an X-ray does not always match the amount of pain experienced. Treatment should therefore be guided by your symptoms, function and clinical assessment rather than the scan appearance alone.

Is the Pain Definitely Coming From the Thumb Joint?

Pain around the thumb and wrist can have several causes. De Quervain’s tenosynovitis, wrist arthritis, tendon irritation and nerve-related conditions can produce symptoms in a similar area.

Your specialist will examine the location of the pain, movement of the thumb, joint stability, grip and pinch function before deciding whether the CMC joint is the most likely source.

An X-ray may be helpful when the diagnosis is uncertain, symptoms are persistent or further treatment is being considered, but imaging is not required in every case.

When Might a Corticosteroid Injection Be Considered?

Corticosteroid injection may be considered when thumb-base osteoarthritis is causing persistent pain that is affecting everyday hand function and appropriate simpler measures have not provided sufficient relief.

It can be particularly helpful when the joint appears irritated or inflamed, or when pain is preventing progress with hand rehabilitation and normal activity.

The decision to inject is individual. Your specialist will consider the diagnosis, severity of the symptoms, previous treatment, medical history and how much the problem is affecting your daily life.

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Treatment Beyond the Injection

Management may include an appropriate thumb-support splint, changes to aggravating tasks, pacing, pain relief and exercises designed to maintain movement and improve the way the thumb is supported during gripping and pinching.

A splint does not necessarily need to be worn continuously. Its design and use should reflect the activities that provoke symptoms and the level of support required.

When symptoms remain substantially limiting despite appropriate non-surgical treatment, referral to a specialist hand surgeon may be considered.

Specialist Thumb-Base Injections in Fareham

Assessment and injection therapy for thumb-base osteoarthritis are provided at our Fareham clinic by Mike Gillingham, Upper Limb Specialist Physiotherapist.

Mike will establish whether the symptoms are genuinely arising from the thumb CMC joint, whether corticosteroid injection is appropriate and how treatment should be combined with splinting, rehabilitation, imaging or onward referral.

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