Osteoarthritis of the Thumb

What is Osteoarthritis?
Osteoarthritis (OA) is the most common form of arthritis and can affect any joint in the
body. Cartilage covers the surface of bones and helps them move freely against each
other. When OA develops, cartilage thins and becomes rougher, and eventually in
severe cases no longer covers the joint surface. This lack of cushioning causes the bone
underneath to thicken, and extra bony spurs may form as the body attempts to repair
the damage. In severe OA, this process may change the shape and movement of the
thumb, as the joint is no longer held in its natural position

OA of the thumb:
The carpometacarpal joint also known as the basal joint is where the trapezium in your
wrist articulates with your first metacarpal bone. This joint is more susceptible to OA
than other finger joints because of its shape, mobility and the forces put through this
joint when using your hand in daily activities.

What are the symptoms?
 Joint pain.
 Stiffness.
 Reduced range of movement.
 Reduced grip.
 Instability

What we can do to help:
 Identify activities that aggravate your symptoms and provide ideas on how to do
these tasks differently to reduce stress over the joint and maintain your
independence.
 Teach you exercises to keep your thumb flexible and your hands strong.
 Discuss strategies to help manage the pain.
 Assess and provide appropriate splints to support the joint and reduce pain during
function.
 Discuss other treatment options.

What you can do to help:
 Gentle heat may be helpful in reducing pain if the area is aching but not very
swollen.
 Ice/cold products may be helpful if the area looks or feels warm, swollen or
tender. Your therapist will advise you on how to do this.
 Pain relief – do not ignore pain! Please check with your GP or pharmacist
regarding options for pain relief.
 Activity modification – changing the way you use your thumb during activities
may reduce the stress and ease pain.
 Using a splint or brace – your therapist will assess and provide a splint if
appropriate.
 Exercise – exercises are beneficial to maintain strength and range of
movement.

Task modification:
General principles include:
 Avoid tight grasp.
 Avoid strong and constant pressure against the pad of the thumb (pinch grip).
 Distribute load over several joints.
 Pace your activities and take regular breaks.
 Use assistive devices to reduce stress over the joint

More information on joint protection can be found on the Versus Arthritis website,
versusarthritis.org

Exercise:
Always exercise slowly and gently. Hold the final position for 2-5 seconds. Your therapist
will guide you about repetition and frequency of exercise

1. Make big circles with your thumb in a clockwise direction, and then repeat in the
   opposite direction.
   Sets_____________ Repetitions_____________

2. With the palm of your hand on the table, stretch your thumb down the side of the table
   as if making an ‘L’.
   Sets____________ Repetitions_____________

3. Perform the same exercise as above, but with the tip of your thumb bent.
   Sets____________Repetitions_____________

4. With the palm of your hand on the table, straighten your thumb out to the side, making
   an ‘L’shape.
   Sets___________ Repetitions_____________

5. Perform the same exercise as no.4 but with the tip of your thumb bent.
   Sets__________ Repetitions_____________

6. Touch the tip of the thumb against the tip of the index, keeping an ‘O’ shape. You may
   need to use the other hand to hold the position first.
   Sets___________Repetitions_____________

What are the other treatment options?
 Steroid injections:
This injection in the joint can help to decrease the symptoms in the short term.
 Surgery:
There are various surgical options but the most common is a surgery called a
trapeziectomy where the trapezium is removed. Surgery involves a lengthy
recovery. Please discuss with your consultant and therapist.

USEFUL CONTACT NUMBERS

Occupational Therapy
Rheumatology Department
Aconbury West
Worcestershire Royal Hospital
Tel: 01905 760462

Occupational Therapy Out-Patient Department
First floor
Aconbury West
Worcestershire Royal Hospital
Tel: 01905 760683

Occupational Therapy
Alexandra Hospital
Redditch
Tel: 01527 512146

Occupational Therapy
Kidderminster Hospital
Tel: 01562 826348

If your symptoms or condition worsens, or if you are concerned about anything,
please call your GP, 111, or 999.

Patient Experience
We know that being admitted to hospital can be a difficult and unsettling time for you
and your loved ones. If you have any questions or concerns, please do speak with a
member of staff on the ward or in the relevant department who will do their best to
answer your questions and reassure you.

Feedback
Feedback is really important and useful to us – it can tell us where we are working well
and where improvements can be made. There are lots of ways you can share your
experience with us including completing our Friends and Family Test – cards are
available and can be posted on all wards, departments and clinics at our hospitals. We
value your comments and feedback and thank you for taking the time to share this with
us.

Patient Advice and Liaison Service (PALS)
If you have any concerns or questions about your care, we advise you to talk with the
nurse in charge or the department manager in the first instance as they are best placed
to answer any questions or resolve concerns quickly. If the relevant member of staff is
unable to help resolve your concern, you can contact the PALS Team. We offer informal
help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf,
if you feel unable to do so, to resolve your problems and where appropriate refer to
outside help.

If you are still unhappy you can contact the Complaints Department, who can investigate
your concerns. You can make a complaint orally, electronically or in writing and we can
advise and guide you through the complaints procedure.

How to contact PALS:
Telephone Patient Services: 0300 123 1732 or via email at: [email protected]

Opening times:
The PALS telephone lines are open Monday to Friday from 8.30am to 4.00pm. Please
be aware that you may need to leave a voicemail message, but we aim to return your
call within one working day.

If you are unable to understand this leaflet, please communicate with a member of staff.

Version 2