Thumb arthritis, also known as basal joint arthritis or thumb carpometacarpal (CMC) joint arthritis, is a condition where the cartilage at the base of the thumb deteriorates, leading to pain, swelling, stiffness, and loss of function. Here's an overview of diagnosis, causes, functional limitations, and the importance of hand therapy, along with common treatments used by hand therapists:

Diagnosis:

  1. Medical History and Physical Examination: The doctor will inquire about symptoms, medical history, and conduct a physical examination to assess thumb mobility, tenderness, and joint stability.

  2. Imaging Tests: The doctor will do X-rays or other interventions to visualize the thumb joint and assess the extent of arthritis, including joint space narrowing, bone spurs, and other degenerative changes.

Causes:

  1. Aging: Wear and tear over time is a common cause, particularly in individuals over 40.

  2. Genetics: Some people may be predisposed to developing arthritis.

  3. Joint Injury: Previous thumb injuries or trauma can increase the risk.

  4. Occupational Factors: Repetitive use or overuse of the thumb joint, such as in certain occupations or activities, can contribute.

  5. Inflammatory Conditions: Conditions like rheumatoid arthritis can affect the thumb joint.

Functional Limitations:

  1. Decreased Grip Strength: Arthritis can weaken grip strength, making it difficult to hold objects or perform tasks requiring manual dexterity.

  2. Limited Range of Motion: Stiffness and pain can restrict thumb movement, impacting activities like grasping, pinching, and twisting.

  3. Difficulty with Fine Motor Skills: Tasks requiring precise thumb movements, such as writing, buttoning shirts, or using utensils, may become challenging.

  4. Pain and Swelling: Pain and swelling can further limit function and diminish quality of life.

Importance of Hand Therapy:

Hand therapy plays a crucial role in managing thumb arthritis by:

  1. Pain Management: Hand therapists employ various techniques to alleviate pain, such as manual therapy, modalities (e.g., heat, ice), and therapeutic exercises.

  2. Improving Function: Hand therapists develop personalized treatment plans focusing on restoring thumb mobility, strength, and coordination through exercises and functional activities.

  3. Joint Protection: Educating patients on ergonomic techniques and adaptive strategies helps minimize stress on the thumb joint during daily activities.

  4. Custom Splinting: Hand therapists may fabricate custom splints to support the thumb joint, reduce pain, and promote proper alignment.

  5. Patient Education: Providing information on self-management strategies, lifestyle modifications, and home exercises empowers patients to actively participate in their recovery and manage symptoms effectively.

Hand Therapy Treatments:

  1. Therapeutic Exercises: Range of motion exercises, strengthening exercises, and proprioceptive training help improve thumb function and stability.

  2. Manual Therapy: Hands-on techniques such as joint mobilizations and soft tissue mobilization can enhance joint mobility and reduce pain.

  3. Modalities: Modalities like ultrasound, electrical stimulation, and paraffin wax baths may be used to relieve pain and inflammation.

  4. Splinting: Custom splints may be fabricated to immobilize the thumb joint, support proper alignment, and reduce stress during activities.

  5. Activity Modification: Hand therapists assist patients in modifying activities to minimize thumb stress and prevent exacerbation of symptoms.

Summary:

Thumb arthritis can significantly impact hand function and quality of life, but with comprehensive hand therapy interventions, individuals can experience improvements in pain, function, and overall hand health. Hand therapists play a pivotal role in managing thumb arthritis by employing a combination of therapeutic techniques tailored to each patient's specific needs and goals.