Hand CMC Arthritis

By Dr. David Graham, MD

What is Thumb CMC Arthritis?

Hand or Thumb CMC Arthritis is inflammation of the thumb joint. Secondary to degenerative arthritis, it is one of the most common sites of osteoarthritis is in the hand. The thumb CMC joint is the most mobile joint in the hand, allowing for a variety of movements and precision activities – such as grasping and picking up objects. Over time, the thumb CMC joint can become susceptible to wear and tear, which for some individuals can result in joint deterioration and arthritis.

Symptoms of Arthritis of the Hand

• Pain in hands after gripping or grasping tasks
• Morning stiffness
• Swelling of the joints
• Joints may feel warm to touch
• Grating or grinding sensation to affected joints
• Cyst formation

Types of Arthritis

1. Osteoarthritis is much more common and is also known as “wear and tear” arthritis, osteoarthritis causes cartilage to wear away. Osteoarthritis affects the large weight-bearing joints such as the shoulders, knees, hips, and spine, and the small joints of the hands, most commonly the thumbs.
2. Rheumatoid arthritis is a chronic disease that can affect many parts of your body. It causes the joint lining (synovium) to swell, which causes pain and stiffness in the joint. It usually affects the same joints on both sides of the body.

Diagnosis of Arthritis

A doctor can diagnose arthritis of the hand by examining the hand and by taking x-rays. A use of the Thumb CMC Grind Test is to assess the osteoarthritis in the carpometacarpal joint of the thumb. The grind test is performed by gripping the patient’s metacarpal bone of the thumb and moving it in a circle and loading it with gentle axial forces.

Treatments of Arthritis of the Hand

Medications

Medications can treat symptoms but cannot restore joint cartilage or reverse joint damage. The most common medications for arthritis are: Anti-inflammatories, which stop the body from producing chemicals that cause joint swelling and pain.

Nonsurgical Treatment

Treatment options for arthritis of the hand and wrist include splinting, injections, and surgery, and are determined based on: Progression of arthritis, Type and number of joints are involved, Age and level of activity, If the dominant or non-dominant hand is affected, Compliance with exercises and post-surgery protocol.

Injections

When first-line treatment with anti-inflammatory medication is not appropriate or not improving the pain, steroid injections may be used. These typically contain a long-lasting anesthetic and a steroid that can provide pain relief for weeks to months. The injections can be repeated, but most surgeons limit the number of times. Due to side effects, such as weakening of the tendons, ligaments, and infection.

 Splinting

Injections are usually combined with splinting of the affected joint. The short opponens splint helps support the affected joint to ease the stress placed on it from frequent use and activities. Additionally, Splints are typically worn during periods when the joints hurt. They should be small enough to allow functional use of the hand when they are worn.

 Surgical Treatment

Dr. Graham is currently performing basilar joint suspensionplasty with an Internal Brace ligament augmentation. Each procedure will fit your individual needs. Talk with Dr. Graham to find out if this surgery is right for you.

Post Surgery

After any joint reconstruction surgery, there is a period of recovery. Often, you will receive a referral to a trained hand therapist who can help you maximize your recovery. You will need to use a splint or cast for a while after surgery to protect the repair. You will need to modify your activities to allow the joint reconstruction to heal correctly. Also, Length of recovery time varies widely and depends on the extent of the surgery performed and Dr. Graham’s CMC protocol.

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Written By: Dr. David Graham, MD.  Dr. Graham is accepting new patients at the JOI Beaches Location.

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