About thumb osteoarthritis

Osteoarthritis is common in the hands and wrists, particularly the fingertip joints and the joints at the base of the thumb. 

In people aged 50 to 60 years, 11% of men and 33% of women have signs of thumb osteoarthritis. 

This figure increases with age. In people aged over 75 years, 25% of men and 40% of women have signs of thumb osteoarthritis. 

Many of these people do not experience significant symptoms or need treatment. 

Causes

We do not know the exact causes of osteoarthritis. It can be more common with increased age, family history, previous joint injuries, joint trauma, overuse of the joint, and in females.

Symptoms

Symptoms may flare up from time to time, then settle down. Common symptoms include the following.

  • Pain especially when pinching, grasping, or twisting. For example, opening a jar or turning a key or door handle.
  • Stiffness and swelling.
  • The ligaments which support the thumb base may loosen, making the thumb less stable.
  • In advanced cases, there may be a ‘bump’ or ‘step’ at the thumb base, and the middle thumb joint may over-extend, producing a ‘zig-zag’ appearance (see photos below). 

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This photo shows the unstable ‘zig-zag’ over an extended thumb position.

Avoid this position, because it stresses the ligaments, is less stable, and can lead to more joint stress and pain.

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This photo shows the stable ‘C-shaped’ thumb position.

Aim to achieve this position in all exercises and activities. 

It can be helpful to use your other hand or a splint to support the thumb position. Only do this if it does not cause you pain.

What you can do to help 

Try the following steps to help yourself.

Pain relief

  • Try warm or cool packs to see which gives you pain relief.
  • Ask your pharmacist about suitable pain relief creams or gels.
  • Keep your hands and wrists moving to maintain range of movement and strength.
  • Try the pain relief and mobility exercises below.
  • Some people find it helpful to use elasticated supports, including thermal or arthritic compression gloves.
  • We may offer you steroid injections for the thumb base joint, especially if other forms of pain relief do not help, and you experience more constant discomfort rather than on and off pain. We can repeat these up to 3 times a year, if helpful.

Splints

Wearing splints may help to support your thumb during everyday tasks. There are many splints on the market, but many people find a soft wrap-around thumb splint helpful.

You can also look online for the ‘Push CMC thumb brace.’  

At night you can wear a firmer splint or custom-made thermoplastic splint, to rest the joint if it is particularly painful.

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Diet

  • Eating a balanced diet and making healthy lifestyle choices can have a beneficial impact on arthritis and general health. These choices include regular physical activity, not smoking, and drinking alcohol in moderation.
  • Diet supplements do not cure arthritis, but some people find their condition is affected by what they eat.  To find out about healthy eating look at Eating Well with Arthritis on the Versus Arthritis website.

Helpful habits

The thumb is necessary for most functional hand activities. If you develop this kind of osteoarthritis, it is important to learn how to adapt your everyday functional activities.

It is a good idea to plan, prioritise, pace and problem solve everyday activities.  

  • Find out more about hand osteoarthritis by watching these patient videos.
  • Take frequent breaks during activities to avoid over-stress.
  • Avoid prolonged, tight, repetitive hand grips during housework, cooking, gardening, or DIY.
  • Use larger hand grips or handles, for example when using cutlery, saucepans and pens.
  • Try using sticky mats to grip things.
  • Use adaptive equipment, such as jar openers, key turners, ring-pull can openers, electric tin openers, twister jar openers, food-processors, kettle pourers, tap turners, and easy-grip knives with chunky handles. Use rubber pen-grippers for writing. Try spring-loaded scissors or secateurs which self-open.
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Avoid using a fingertip grip, as this increases the compression pressure at the thumb base and may cause irritation.
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Use a full palm grip, rather than fingertip grip.  If you’re lifting heavy items, use both hands and support from underneath.
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‘Key’ grip increases thumb base pressure, so use two hands with an open palm instead.

​​To find out more, look at Gadgets and equipment for your home on the Versus Arthritis website.

Exercises

Daily exercises are important to improve and maintain muscle strength, flexibility, and joint range.  You may choose to do some exercises in the mornings and others in the evenings.

Only do these exercises if they are pain-free. Progress them gradually. 

Pain relief and mobility exercises

Pulling thumb joint

Gently distracting or pulling the thumb joint can relieve pain for some people.

  • Hold for 5 to 10 seconds.
  • Repeat 3 to 5 times.

Do not follow this technique if it causes you pain.

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The muscles of the base of the thumb can get tight and restricted.

To relieve them, try gentle massage using the knuckle of your other hand or a massage tool.

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Stretch the webspace between the thumb and index finger, to maintain a right angle.

Take care not to over-extend (bend back) the thumb joints.

  • Hold for 30 seconds.
  • Repeat 3 times.

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Sustained-hold exercises can be helpful for pain relief.  

Apply gentle resistance close to the joint at the base of the thumb, using your other hand.  Press gently against it on top and then below, without moving the thumb.

  • Hold for 10 seconds.
  • Repeat 3 to 5 times in each direction.
  • Keep the exercise pain-free.

 

Stability exercises

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This exercise activates an important thumb stability muscle.

Rest the side of your hand on a table.

Put your index and middle fingers into a 'bunny ears' position.

Gently lift and lower the index finger, away from the middle finger.

  • Hold for 10 seconds.
  • Repeat 10 times.

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You can add an elastic band or your other hand for gentle resistance.

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Make a loose fist.

Place a light elastic band around your index finger and thumb, or use your other hand for resistance.

Keeping the tip joint of your thumb bent, slide your thub away from your hand, keeping it in contact with the table.

  • Hold for 10 seconds.
  • Repeat 10 times.

Pinch grip

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Keep the rounded C shape.

Move the thumb towards the index finger, making an O shape.  Gently squeeze and release.

  • Repeat 10 times.

You may need to gently support the base of your thumb to prevent it over-extending.

You can progress this exercise by moving the thumb to each fingertip in turn, or by adding a sponge or putty-like substance (Blu-tack or Play-doh) as gentle resistance.

Only continue with this exercise if you have full control of your thumbs.

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This exercise helps with dexterity.

Write numbers randomly on a table tennis ball.

Turn the ball to look at each number in turn, while keeping the thumb and index finger in the rounded 'C' shape.