Basilar Thumb Arthritis

By Dr. Garry Kitay, Orthopedic Hand Surgeon

1st CME Joint or Thumb Arthritis

Basilar thumb arthritis is arthritis at the base of the thumb. It happens at a joint called the 1st carpometacarpal joint or CMC. Basilar thumb arthritis is the second most common type arthritis in the hand.

Watch this VIDEO on Basilar Thumb Arthritis by Dr. Garry Kitay

Thumb Arthritis JOI

1st CMC joint thumb x-ray

Who is at Risk of Arthritis at the Base of the Thumb?

Women are more likely to develop arthritis at the base of the thumb. This type of arthritis is also more common with people who have loose ligaments. Loose ligaments may be known as being “double jointed”. It can be very painful.

Why is Basilar Thumb Arthritis so Painful?

Arthritis is the base of the thumb can be very painful.   This is due to the frequency of use for this joint in the hand. Many people consider the 1st CMC joint as the most important joint in the hand.

The 1st CMC joint allows the thumb to work with all of the other figures and oppose them to grasp or pinch.

Activities that Are Difficult with Basilar Thumb Arthritis

  • Twisting a twist tie
  • Opening a jar
  • Shaking hands

Diagnosis of Basilar Thumb Arthritis

Arthritis at the base of the thumb is usually diagnosed with an X-ray of the joint.  A physician may also stress the 1st CMC joint to see if it reproduces the pain.

Treatment of 1st CMC Thumb Joint Arthritis

Conservative treatment of 1st CMC joint arthritis may include a splint. A common splint is a Short Opponens splint. The splint can limit excessive movement of the joint and allow the inflammatory process to calm.

Oral medications medications are helpful with basilar thumb arthritis is some cases. Steroid injections in the joint may be used if oral or conservative treatments do not help.  In therapy, fluidotherapy, moist heat, electrical stimulation and a paraffin treatment can help reduce the pain and inflammation.

In some cases, surgery is needed to treat severe basilar thumb arthritis.

Surgery for Thumb Arthritis

Arthroscopic surgery may be an option if the arthritis is mild to moderate.  Arthroscopic surgery allows the surgeon to debride or remove damaged tissue and smooth the joint surfaces. This option can be effective for decreasing pain and increasing function in the hand.

Arthroplasty may be an option in some severe cases of CMC joint arthritis. Arthroplasty allows the surgeon to remove bone spurs and the damaged joint surface. The surgeon may place a tendon in the joint to act as the new cushion for the joint.

How Long is Recovery after 1st CMC Arthroplasty?

  1. Weeks 1-4 – CMC is immobilization to allow time for healing.
  2. Weeks 4-8 – May begin therapy and start regaining range of motion.
  3. Weeks 8-12 – Begin working on strength training and return to function.

We hope that this article has been helpful in identifying CMC Thumb Joint or Basilar injuries.  JOI has an experienced team of physicians and therapist who can help treat this injury.  Give us a call!


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If you have pain in your thumb, Dr. Kitay and team at JOI can help. To make an appointment with Dr. Garry Kitay, call (904)JOI-2000, schedule online, or click the link below. Finally, to see a JOI Rehab Therapist is 1 of our convenient locations, call (904)858-7045.

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