Hand and Thumb Arthritis: Complete Guide to Non-Surgical and Surgical Treatment From a Hand Surgeon Near You

Key Takeaways

• Hand and thumb arthritis happens when the cartilage that cushions a joint wears down or becomes inflamed, causing pain, stiffness, swelling, and a weaker grip.
• Arthritis at the base of the thumb is very common, and it often shows up as pain when you pinch, grip, turn a key, or open a jar.
• Most people start with splints, hand therapy, activity changes, medication, and injections, which can ease pain but cannot reverse arthritis.
• Surgery is considered when pain keeps limiting daily life. The main options are joint fusion, which stops a joint from moving to end the pain, and joint replacement, which aims to keep the joint moving.
• Recovery after hand arthritis surgery usually involves a splint, hand therapy, and a gradual return to activity over several weeks to months.
• Dr. Mark A. Yaffe is a double board-certified hand doctor who offers single-incision thumb arthritis surgery in Buffalo Grove, Schaumburg, Elk Grove Village, and Bartlett, IL. Request an appointment online or call (847) 285-4200 to start feeling better.

Appointments

Why Arthritis Hits the Hands So Hard

Your hands contain many small joints that work together every time you pinch, grip, write, or turn a key. Arthritis means a joint is inflamed or worn down. In the hand, it most often develops when cartilage wears away. Cartilage is the smooth, rubbery tissue that covers the ends of bones, and without it, the bones begin to rub against each other.

The thumb takes on a lot of that work. According to a Mayo Clinic Q&A on thumb arthritis, about 8 to 12 percent of the population has arthritis of the thumb joint. That makes the thumb the second-most common part of the hand to have arthritis. It also affects more than half of women 70 and older.

Dr. Mark A. Yaffe is double board-certified by the American Board of Orthopaedic Surgery in orthopaedic surgery and hand surgery. He earned his medical degree and completed his orthopaedic residency at Northwestern University Feinberg School of Medicine. He then trained in hand and upper extremity (arm) surgery at The Indiana Hand to Shoulder Center. He offers hand and finger arthritis treatment in Buffalo Grove, Schaumburg, Elk Grove Village, and Bartlett, starting with the least invasive approach that will work for you.

Types of Arthritis That Affect the Hand

Before looking at the types of arthritis, it helps to know the four joints hand doctors talk about most:

• Carpometacarpal (CMC) joint: The joint at the base of the thumb, where the thumb meets the wrist
• Distal interphalangeal (DIP) joint: The joint closest to the fingertip
• Proximal interphalangeal (PIP) joint: The middle joint of the finger
• Metacarpophalangeal (MCP) joint: The knuckle where the finger meets the hand

Osteoarthritis, often called wear-and-tear arthritis, is the most common type in the hand. Rheumatoid arthritis and other inflammatory types may need care coordinated with a rheumatologist, a doctor who treats inflammatory joint disease, which is one reason an accurate diagnosis matters. Arthritis can also affect the wrist, which Dr. Yaffe covers in his article on wrist arthritis symptoms, causes, and treatment options.

Signs of Arthritis at the Base of the Thumb

According to Mayo Clinic's thumb arthritis overview, pain is the first and most common symptom of thumb arthritis. You often feel it at the base of the thumb when you grasp or pinch something. 

Other signs include:

• Swelling, stiffness, and tenderness at the base of the thumb
• Less range of motion, such as trouble spreading the thumb away from the palm
• A joint at the base of the thumb that looks larger or bony
• A weak pinch or grip that makes it hard to hold a cup, carry groceries, or turn a doorknob
• A grinding or clicking feeling when you move the thumb

In advanced cases, the thumb can drift toward the palm, and the next joint up may bend backward to make up for it. This is one reason early evaluation is worthwhile.

Signs of Arthritis in the Fingers

• Aching in the finger joints or knuckles, especially with gripping, pinching, or writing
• Stiffness after waking up or sitting still
• Puffy, tender joints that may feel warm
• Hard, bony lumps near the middle or end joints of the fingers
• Fingers that slowly drift or look crooked
• A weaker grip and trouble with fine tasks like buttoning a shirt

Who Is More Likely to Develop Thumb Arthritis?

Base-of-thumb arthritis is most common after age 40 and is seen more often in women. Mayo Clinic lists several other factors that can raise your risk:

• Getting older
• Past injuries to the thumb joint, such as fractures and sprains
• Inherited traits, such as loose joint ligaments or joints that didn't form correctly
• Conditions like rheumatoid arthritis that change how cartilage forms and works
• Activities and jobs that put high stress on the thumb joints

How a Hand Doctor Diagnoses Hand Arthritis

Diagnosis starts with a conversation about your symptoms and a hands-on exam. Dr. Yaffe checks each painful joint for tenderness, swelling, motion, strength, and stability.

X-rays confirm arthritis and show how advanced it is. They can show narrowing of the space between the bones, which means cartilage has worn away. They can also show bone spurs, which are small bony growths along the edges of a joint. If an inflammatory type of arthritis is suspected, Dr. Yaffe may recommend further testing or coordinate your care with other specialists.

Before your visit, it helps to note which joints hurt most, which activities bother your hand, and what treatments you've already tried.

Splints, Therapy, and Injections: Non-Surgical Treatment

Non-surgical care cannot reverse arthritis, but it can reduce pain and help you keep using your hands comfortably. Mayo Clinic notes that for most people with thumb arthritis, these therapies can effectively lessen symptoms, and surgery may not be necessary.

Splints and Braces

A splint or brace holds the thumb or finger in a supported position so the joint can rest. For base-of-thumb arthritis, a splint that supports both the thumb and part of the wrist can make pinching and gripping more comfortable during a flare.

Hand Therapy and Joint Protection

A certified hand therapist can teach you exercises to keep your joints moving, along with ways to protect them during daily tasks. Small changes add up:

• Replace round doorknobs with lever-style handles, which Mayo Clinic notes can help rest the thumb joint and lessen pain
• Use jar openers, key turners, and pens with thicker grips
• Carry bags over your forearm instead of pinching the handles
• Take short breaks during long stretches of gripping, typing, or gardening

Injections

A steroid injection, sometimes called a cortisone shot, places anti-inflammatory medicine directly into the joint. Injections can ease pain for some patients, but the relief varies and is often temporary, and they do not repair worn cartilage. For some patients with early arthritis, Dr. Yaffe may also discuss orthobiologic injections such as PRP. He can explain whether an injection makes sense for you based on your exam and X-rays.

When Surgery Makes Sense

There is no single right time for surgery. Mayo Clinic notes that surgery is usually a last resort for thumb arthritis, and Dr. Yaffe will walk through your options with you. Surgery is worth discussing when:

• Pain continues despite splints, therapy, medication, and injections
• Arthritis interferes with daily tasks, work, hobbies, or sleep
• A joint has become very stiff, weak, or deformed
• You are healthy enough for surgery and the hand therapy that follows

Joint Fusion vs. Joint Replacement

When a finger joint needs surgery, the two main options are joint fusion and joint replacement. According to OrthoInfo from the American Academy of Orthopaedic Surgeons, the right choice depends on which joint is involved and what you need the joint to do.

• Joint fusion (arthrodesis): The damaged joint is removed, and the bones are connected with pins, wires, plates, or screws so they heal together. The joint no longer moves, but fusion relieves pain and has excellent longevity.
• Joint replacement (arthroplasty): The worn joint surfaces are removed and replaced with artificial implants designed to mimic natural movement. Implants may be made of silicone, pyrocarbon (a durable carbon material), or metal and plastic.

OrthoInfo also notes that finger joint replacement probably will not improve how far the finger moves. The main benefit is relief of pain during the motion you already have.

Surgery for Base-of-Thumb Arthritis

The thumb's CMC joint is treated a little differently. Surgical options for the thumb include removing the arthritic trapezium bone at the base of the thumb, joint fusion, and, in select cases, joint replacement. Removing the trapezium and rebuilding support for the thumb is among the most established surgical treatments for thumb arthritis.

Dr. Yaffe's Single-Incision Thumb CMC Arthroplasty

Dr. Yaffe has published on minimally invasive thumb joint arthroplasty, a surgery that rebuilds the joint at the base of the thumb. He performs base-of-thumb (CMC) arthritis surgery using a single-incision technique. He removes the arthritic trapezium bone and transfers a slip of a nearby tendon, the abductor pollicis longus (APL), to support the base of the thumb. Unlike standard techniques, his approach does not require cutting or harvesting a tendon, which can mean a quicker recovery and less pain after surgery.

The outpatient procedure takes about 45 minutes and is usually performed at Schaumburg Surgery Center, located inside the main office of Barrington Orthopedic Specialists. For the right patients, Dr. Yaffe also offers thumb CMC joint replacement surgery through a single incision, with a removable splint instead of a cast afterward.

Recovery After Hand Arthritis Surgery

After Thumb CMC Arthroplasty

After surgery, the thumb is padded and placed in a splint to protect it while it heals. You can start light daily activities in the splint right away. Heavy lifting is restricted for 6 to 8 weeks, until the splint is no longer needed. Dr. Yaffe's patients work with certified hand therapists to regain motion and strength, although many need only minimal therapy.

After Finger Joint Replacement

Hand therapy is essential after finger joint replacement. OrthoInfo shares this example of a typical recovery:

Dr. Yaffe typically uses a removable splint rather than a cast after hand joint replacement, so you can take it off for therapy exercises. Recovery timelines vary from patient to patient and depend on which joint was treated.

Find a Hand Doctor Near You in Buffalo Grove, Schaumburg, Elk Grove Village, or Bartlett

Dr. Yaffe treats hand and thumb arthritis at the Barrington Orthopedic Specialists offices listed below. Call (847) 285-4200 to schedule at the location most convenient for you.

Ease Thumb and Finger Arthritis Pain With Dr. Mark A. Yaffe

Hand and thumb arthritis can't be reversed, but the right mix of splints, therapy, injections, and, when needed, surgery can ease pain and keep your hands working. Dr. Yaffe tailors each plan to the joints involved and your goals, including a single-incision thumb surgery designed for a smoother recovery.

Request an appointment online with Dr. Mark A. Yaffe for base-of-thumb arthritis treatment or hand and finger arthritis care, or call (847) 285-4200 to schedule a visit at his Buffalo Grove, Schaumburg, Elk Grove Village, or Bartlett office.

Frequently Asked Questions