Summary about Disease
Trapeziometacarpal osteoarthritis (TMC OA), also known as thumb base arthritis, is a degenerative joint disease affecting the carpometacarpal (CMC) joint at the base of the thumb. This joint, where the trapezium bone of the wrist meets the first metacarpal bone of the thumb, is crucial for thumb movement and function. The cartilage that cushions the bones in this joint breaks down over time, leading to pain, stiffness, and decreased range of motion.
Symptoms
Pain at the base of the thumb, especially with gripping, pinching, or twisting.
Stiffness at the base of the thumb.
Tenderness to the touch at the base of the thumb.
Swelling around the thumb base.
Decreased range of motion in the thumb.
Weakness in grip strength.
A grinding sensation or sound (crepitus) with thumb movement.
Visible bump or deformity at the base of the thumb in advanced cases.
Causes
Age: The most common cause; risk increases with age.
Genetics: Family history of osteoarthritis.
Previous Injury: Trauma to the thumb joint (e.g., fracture, sprain).
Repetitive Use: Activities involving repetitive thumb movements.
Ligament Laxity: Weakness or looseness of the ligaments supporting the joint.
Gender: More common in women.
Underlying Conditions: Other types of arthritis may increase risk.
Medicine Used
Pain Relievers:
Acetaminophen (Tylenol).
Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin) or naproxen (Aleve).
Topical NSAIDs (e.g., diclofenac gel).
Prescription pain medications (in severe cases, short-term use).
Corticosteroid Injections: Injected directly into the joint to reduce inflammation and pain.
Disease-Modifying Osteoarthritis Drugs (DMOADs): Although research is ongoing, some DMOADs show promise in slowing down OA progression. (e.g., hyaluronic acid injections).
Is Communicable
No, trapeziometacarpal osteoarthritis is not communicable. It is a degenerative condition and cannot be spread from person to person.
Precautions
Avoid Activities That Aggravate Pain: Modify or avoid activities that worsen your symptoms.
Use Assistive Devices: Jar openers, specialized tools, and adaptive equipment can reduce stress on the thumb joint.
Maintain a Healthy Weight: Excess weight puts more stress on all joints.
Strengthen Supporting Muscles: Exercises to strengthen the muscles around the thumb and wrist.
Splinting: Wear a thumb splint to support the joint, reduce pain, and promote healing.
Ergonomics: Use proper ergonomics when performing tasks to reduce strain on the thumb.
Warm-up and Stretch: Prepare your hands and wrists before engaging in activities that may stress the thumb joint.
How long does an outbreak last?
There are no outbreaks. TMC OA is a chronic condition, so there aren't distinct outbreaks in the infectious sense. Symptoms may fluctuate in intensity over time (flare ups), lasting from a few days to weeks. Pain and functional limitations may increase gradually over many years.
How is it diagnosed?
Physical Examination: Doctor will examine the thumb and hand, checking for tenderness, swelling, range of motion, and strength.
Medical History: Doctor will ask about symptoms, medical history, and activities.
X-rays: X-rays are the primary imaging tool to visualize the joint space, bone spurs, and other signs of osteoarthritis.
Other Imaging: MRI or CT scans are rarely needed but can be used in complex cases or to rule out other conditions.
Timeline of Symptoms
The progression of TMC OA varies:
Early Stages: Mild pain and stiffness, especially after activity. Symptoms may come and go.
Intermediate Stages: Pain becomes more frequent and intense. Stiffness increases, and range of motion decreases. Activities become more difficult.
Late Stages: Chronic, severe pain. Significant stiffness and limited range of motion. Deformity of the thumb base may be visible. Daily activities are significantly affected.
Important Considerations
Early Diagnosis and Treatment: Early intervention can help manage symptoms and slow down the progression of the disease.
Individualized Treatment Plan: Treatment should be tailored to the individual's symptoms, activity level, and overall health.
Non-Surgical Options First: Non-surgical treatments are usually tried first, with surgery considered if these are ineffective.
Surgical Options: Various surgical procedures are available, including joint fusion (arthrodesis), joint replacement (arthroplasty), and ligament reconstruction.
Long-Term Management: TMC OA is a chronic condition that requires ongoing management to maintain function and quality of life.
Consult a Specialist: Seek evaluation and treatment from a hand surgeon or rheumatologist experienced in managing TMC OA.