Thumb base pain case study

Mrs Smith is retired and 67 years old, she has noticed for several months’ pain and swelling around the base of her right thumb.  She struggles to grip objects due to the pain. Mrs Smith feels the pain has limited her every day function and leisure activities. She struggles to hold a book while reading and has difficulty opening jars or using cooking implements such as a potato peeler.

Osteoarthritis (OA) is the most common form of arthritis in the UK. It is a degenerative disease which affects people with increased age. OA of the thumb base is more common in women than men or there may be a history of OA in the family. Osteoarthritis is the “wear and tear” of the joint cartilage and bone tissue. The cushion-like cartilage wears away over time and results in the bone rubbing against bone producing pain, swelling and limited movement. You may notice a bony bump or protuberance over the base of the thumb joint at the wrist.

Thumb base osteoarthritis is not only painful but also restricts people carrying out  very basic activities because they lose their ability to move their thumb normally and make a pinch grip, making it difficult to hold a pen, do up buttons, pick up a glass or use scissors or clothes pegs.

Individuals are affected by thumb OA in different ways and there are a variety of treatment options that may work for each particular symptom. Initial treatment may involve referral to a hand therapist.

A Hand therapist will be able to assess your condition and plan an individual treatment programme to improve pain, movement and function.  Provide advice and education regarding Osteoarthritis, treatment options and facilitate treatment decision-making.

A treatment programme would involve specific thumb exercises to improve the strength and stability of muscle to “sandwich” or support the thumb base joint. Gentle stretches may be demonstrated to improve movement. If appropriate a hand therapist may provide a pre-fabricated or made-to-measure thumb splint to support the thumb joint during heavy tasks, functional activity or for comfort during periods of pain.

A Hand therapist would also discuss with you methods for reducing the stress on your joints, pacing, modifying your daily activities and equipment to aid the thumb during function. For example, using a large grip on kitchen utensils or writing pens will reduce the amount of muscle power required to grip.

Page last reviewed on 03/11/2015