Basal Joint Arthritis

If you break or sprain your thumb you can damage the cartilage. Any injury, even if it doesn't damage the cartilage, can change the way your joint works. You could break the metacarpal bone and the pieces of bone might not quite line up properly when they are healing. Or you might damage the ligaments when you sprain your thumb.
All these things can make the joint work differently from the way it is supposed to work.

When things in machinery do not line up right the machine will wear out faster. It's the same with a joint. When it's not working quite the way it's supposed to work it will wear out faster. The extra pressure on the cartilage might damage it and cartilage does not heal itself very well.
Eventually the joint will start to hurt. But the damage is done long before it does start hurting

Pain and stiffnes is the main problem with arthritis in any joint. In the beginning it's painful when you first start moving the joint. Then, once you get going the pain will go away or lessen. But after resting for a while the pain and stiffness will increase.

Later on, as the condition becomes worse, you might have pain even when you aren't using your thumb. And it becomes hard to grip things and hold them.
There will be a sharp pain at the base of your thumb and the heel of your hand.

Eventually, once the cartilage is really wearing thin, you'll hear a squeaking sound when you move your thumb.

When you have basal arthritis it can become almost impossible and very painful to try to move them thumb away from the palm of the hand. This is called contracture.

The doctor will examine your thumb and ask you about any injuries you might have had to your thumb.
He will send you to have an X-Ray and from that he can determine how much damage the arthritis has done to the joint. From looking at the X-Ray he can determine approximately how much the cartilage has worn down.

Non Surgical Treatment

There are some choices of treatment, depending on how serious the condition is.

• physical therapy
  
• anti inflammatory medicines like ibuprofen or aspirin
  
• cortisone injections
  

The physical therapist will teach you how to control the symptoms by using heat, rest or special exercises. He/she will will show you ways of how to reduce pressure on the joint. You might need to wear a brace. You will be shown exercises to make your hand more steady so the thumb joint will be protected from shock and stress

The doctor will prescribe medication and probably advise you what cream or other topical medicine you could use to relieve the pain.

When the pain gets more severe the doctor might give you a cortisone shot in the joint. This might give you relieve for a few weeks or maybe even a few months.

When the condition becomes more serious, and usually as a last resort there is always the option for surgical treatment.

There ares several options of surgical treatment for basal joint arthritis.

Joint Replacement

There are artificial replacements for basal joints.Doctors used silicone joint replacements till there was a problem with silicone breast implants. Doctors stopped using silicone for any surgery and went back to fusion and excisional arthroplasty.
But now there are other materials used for joint replacement and doctors have gone back to replacig arthritic joints again.

Fusion

With fusion the two bones forming the joint are allowed to grow together to form one solid bone. Hand surgeons like to use fusion of the basal joint when doing surgery on young people. By solving the problem of pain this way people will be able to keep their strong grip. People doing heavy work will prefer this surgery. They rather have a strong grip than all the finer movements of the thumb.

Excisional Arthroplasty

This is the traditional surgery for basal joint arthritis. The arthritic surfaces of the joint bones are removed and replaced by other material that will replace the worn cartilage and separate the bones.
The surgeon will use a rolled up tendon and place it between the two bones. The tendon will turn into a tough scar tissue and form a flexible connection between the two bone, just like a joint.

After surgery your hand will be bandaged and padded and your thumb will be in a splint. It will take a minimum of eight weeks of physical therapy to get your joint back intoshape.