Does your thumb hurt too? Let's talk about thumb arthritis!

The thumb is a very important finger on our hand. Think about it, turning a key, holding a cup, moving the `screen` of the phone back and forth, writing, drawing... All of these things are impossible without the thumb. But, have you ever thought that this precious joint of the thumb could one day become painful, swollen, and unable to perform daily tasks? Yes, this is a problem for many people, especially with age. Today we are talking about this condition called thumb arthritis.

What is Thumb Arthritis?

Simply put, thumb arthritis is the breakdown of the protective cartilage in the joints of your thumb. This cartilage is like the shock absorbers in a car. It acts as a cushion that helps the bones in the joint move smoothly without rubbing against each other. Over time, as we use our hands, this cartilage wears down. In medical terms, this is called osteoarthritis.

Most often, this arthritis occurs at the carpometacarpal (CMC) joint in your thumb. This is located near the wrist, at the base of the thumb, in the fleshy part of your hand. It is sometimes called the basal joint. The CMC joint is what helps your thumb move easily from side to side and grip things tightly. That's why doctors call it CMC arthritis. In fact, after arthritis in the joints of the fingers, this is the most common type of arthritis in the hand.

Do you also have these symptoms?

Now let's look at what symptoms you might experience if you have big toe arthritis. Not everyone will experience these symptoms the same way, but these are the most common:

• Feeling achy or uncomfortable in your thumb after using your hand for a long time. Imagine, if you spend a lot of time working in the garden, writing something, or doing household chores, such as cooking, your thumb will start to hurt after a while.
• At the base of the thumb, where the `CMC` joint is, a small bone spur can develop. That is, a small protrusion that forms on top of the bone.
• The joint of the thumb appears enlarged and swollen. Sometimes it may even be red.
• The strength of the thumb decreases, and it becomes difficult to move it properly. For example, it becomes difficult to open a water bottle cap, open a jar of jam, or turn a key. It becomes difficult to grip anything firmly with the hand.
• The thumb hurts badly when grasping, gripping, or pinching something with the fingertips. It can feel like a sharp pain from the inside.
• You may feel swelling, stiffness, or tenderness at the base of your thumb. You may find it difficult to bend or straighten your thumb when you wake up in the morning.

If you have these symptoms, it's best to see a doctor right away.

Why do we get big toe arthritis?

As mentioned earlier, the main cause is the degeneration of the cartilage in the thumb joints. This cartilage is a membrane that prevents the bones from rubbing against each other and gives the joints their smoothness. With age and as we continue to use our hands, this cartilage naturally wears down. What happens is that the bones underneath start to rub against each other. This causes pain, swelling, and damage to the joint.

Who is most at risk for this?

Not everyone gets this. But some people are more likely to get this condition. Let's see who they are:

• For women: Women are more likely to develop this big toe arthritis than men.
• Over 40 years of age: As we age, many things in our bodies wear out, and it is normal for the cartilage in our joints to wear out as well.
• Genetic predisposition: If someone in your family, like your mother or father, has osteoarthritis, you may have a genetic predisposition to developing it too.
• Previous thumb injuries: If your thumb has been broken, severely bruised, or sprained, you may develop arthritis in the future.
• Other health conditions: People with other diseases that affect the joints, such as lupus and rheumatoid arthritis, are also at risk of developing this big toe arthritis.

How does a doctor detect this?

When you go to see a doctor with the symptoms you mentioned above, he will first ask you about your symptoms.

• How long has this pain been there?
• Does your thumb hurt all the time, or does it only hurt when doing certain things?
• Have you ever had any previous injuries to your thumb?

You can ask questions like.

Then the doctor will examine your hand and thumb. He may hold the joint of your thumb and move it in different directions. Then,

• If you feel pain when you move your thumb back and forth,
• If you feel a "gritty feeling" like something is stuck inside the joint, like grains of sand,
• If you hear a "crackling" sound (`crepitus`) as the bones rub together,

The doctor may suspect that this could be big toe arthritis.

To confirm the diagnosis, your doctor may also order an X-ray. An X-ray can show the extent of cartilage wear at the joint, whether the bones are rubbing together, or whether bone spurs have formed.

What are the treatments for this?

Treatment for big toe arthritis varies depending on the severity of your symptoms.

Treatments you can do at home

In the early stages, if the symptoms are not too severe, your doctor may recommend simple treatments you can do at home, such as:

• Ice or heat: Apply an ice pack or a heating pad to the joint of your thumb for 5 to 15 minutes several times a day. Try both and see what gives you relief. Some people find ice helpful, while others find heat helpful.
• Painkillers: To reduce pain and swelling, you can take nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil®), aspirin (Aspirin), or acetaminophen (Tylenol®). But remember, do not take these medications continuously without consulting a doctor.
• Wearing a Splint: Your doctor may recommend that you wear a splint to rest your thumb joint and prevent it from moving unnecessarily. You can wear this during the day or while you sleep at night. This can help reduce pain and help the joint heal faster.

Medical treatment

If home care does not relieve the pain, or if symptoms worsen over time, your doctor will tell you about other medical treatments.

• Steroid Injections: In this, a steroid is injected directly into the CMC joint of the thumb, where there is pain and swelling. This usually provides good pain relief for a few months. However, the benefits of these injections may wear off over time. Also, it is not good to get these injections frequently.

When is surgery necessary?

If all other treatments fail to control the pain and the function of your thumb is so impaired that you can't perform daily activities, your doctor may suggest surgery. There are several types of surgery for thumb arthritis:

• Arthroplasty (joint replacement): In this, the damaged joint of the thumb is completely or partially removed and replaced with an artificial joint (artificial implant).
• Denervation: This does not directly alter the junction. Instead, it blocks signals from the nerve endings that carry pain signals to the brain. This reduces the sensation of pain.
• Fusion (arthrodesis): This involves fused the bones of the thumb joint together to make it permanent. This can significantly reduce pain and increase strength. However, the movement of the thumb joint is limited. This means that the joint cannot be bent or extended.
• Ligament Reconstruction and Tendon Interposition (LRTI): Although it sounds a bit complicated, this involves removing part of the damaged joint (usually a small bone called the trapezium) and using a tendon near the wrist to create a hinged thumb joint. This can reduce pain and maintain some range of motion.
• Trapeziectomy with suspensionplasty: This is a procedure that is somewhat similar to LRTI. A portion of the damaged joint is removed and the thumb is suspended using nearby tendons or strong sutures. This also reduces pain and allows for movement.

Your doctor will decide which surgery is best for you, taking into account your condition, age, and your needs.

What can I expect with this situation?

Arthritis of the big toe is a largely manageable and treatable condition. Many people can significantly reduce their symptoms with the non-surgical treatments mentioned above, such as home care, medication, and splints. Surgery is considered only if there is no relief.

Sometimes your doctor may recommend physical therapy or occupational therapy . A certified hand therapist, who is specially trained in hand disorders, can help you regain strength, movement, and function in your hand and thumb. They can teach you specific exercises, ways to make everyday tasks easier, and ways to protect your joints.

The most important thing to remember (Take-Home Message)

Think about how many things we use our thumbs for every day, like turning keys, holding books, and swiping on a tablet screen. But when you develop arthritis in your thumb, even this simple task can become painful. It's more common than you think, and it can have a big impact on your daily life.

So, if you experience pain, swelling, stiffness, or numbness in your thumb, don't just ignore it and see a doctor. He or she can help you find relief and teach you ways to make your daily activities easier. The sooner you start treatment, the sooner you can recover.

` Arthritis, Thumb Pain, Osteoarthritis, CMC Arthritis, Joint Pain, Hand Pain, Thumb Arthritis