Arthritis is characterized by destruction of the joint surfaces resulting in pain, stiffness, and inflammation, or swelling of the joints. This may be a result of either inflammatory processes, as in rheumatoid arthritis (RA) or degenerative changes of overuse or trauma, as in osteoarthritis (OA).
Osteoarthritis, or degenerative arthritis, is a condition that develops from the gradual “wear and tear” on the joints. Cartilage covers the ends of the bones. The cartilage creates a smooth surface that protects the bones from wearing down by allowing them to glide against each other. With osteoarthritis, the cartilage slowly wears away until the bare, unprotected ends of the bones begin to rub together, destroying the joint and causing pain, swelling and stiffness.
One of the most common arthritic conditions of the hand involves the joint at the base of the thumb and wrist. This condition is called Basilar Joint Arthritis. The basilar joint is formed by a small bone in the wrist (trapezium) and the first bone in the thumb (metacarpal). This joint enables the thumb to move in many directions for gripping and pinching. This condition is more frequently seen in women and is thought to be related to activities that require repetitive, resistive pinching and/or bend of the thumb.
Significant arthritis and deformity of the joint at the base of the thumb results in disabling pain and loss of hand function.
Early symptoms of arthritis in the hand or wrist include:
hand weakness, difficulty gripping and turning things like a key, door knob or jar lid;
thumb/hand hurts with weather changes, such as cold, rainy days;
thumb hurts with overuse;
and a notable lump in your wrist near the base of the thumb.
Surgical intervention may be needed if the condition becomes severe with marked deformity and joint destruction.
Conservative treatment of arthritis can be beneficial for patients in both earlier and more advanced stages to decrease pain and inflammation. Your doctor may prescribe anti-inflammatory medicine, protective splints/braces and resting the joints. You may also be referred to a therapist for early treatment.
What to expect from therapy
The goals of therapy include increasing mobility, joint stability and functional use of the hand and arm. Your therapy program will include education in the disease process and joint protection, exploration and use of adaptive equipment and techniques, energy conservation, movement and gentle exercises, pain reduction techniques and splinting to protect the joints. Involvement in a conservative treatment program may offer you enhanced control over the disease and symptoms; therefore, decreasing potential deforming and destructive forces on the joints. Your therapist will help you gain/maintain the greatest level of functional use of your hands for your daily activities.