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Thumb arthritis causes pain at the base of the thumb. In advanced cases, it leads to joint deformity. To stop the process and relieve pain, many solutions exist. Find out what are the most common thumb arthritis treatments according to the recommendations of the European League Against Rheumatism(1, 2, 3).
Thumb arthritis: treatments for mild to moderate cases
The thumb arthritis treatment must be adapted to the severity of the condition. Firstly, it is recommended to opt for ergonomic tools and to do some exercises that improve muscle function and reduce pain.
Wearing a brace for resting periods that immobilises the painful joint in a long term is particularly appropriate. For this reason, EPITACT® has created a flexible day brace* aiming to make its user aware of traumatic micromovements in order to correct them intuitively. Another brace for thumb arthritis* has been developed to immobilise the joint in a resting position, mainly at night.
When pain is too intense, topical NSAIDs (non-steroidal anti-inflammatory drugs) in cream or gel form are preferred compared with oral analgesics.
It is essential, for any prescription, to monitor the impact on daily activities and to inform patients about the possibilities to protecting the joints. It is necessary that health professionals provide support devices to help in the daily life, such as braces created to immobilise the trapeziometacarpal joint. Therefore, self-medication should be banned: only a health professional can suggest you the appropriate treatment.
Thumb arthritis: treatment with drugs
Drug therapy is required if the previous treatments were not effective enough. Punctual use of paracetamol to be taken orally and then NSAIDs, if necessary, can increase the relief of symptoms.
Chondroitin sulfate can be used to relieve pain in the short term and to improve joint function. It would slightly reduce arthritis attacks.
Corticosteroids or hyaluronic acid can also be suggested. Some studies show that hyaluronic acid is less efficient in the short term (< 6 weeks) than corticosteroids, but more efficient in the long term (after 6 months). Injections would be more efficient on pain than on grip strength or joint mobility. Recent studies indicate that corticosteroid injections in the joints shouldn’t be used in patients suffering from hand arthritis but can be prescribed for patients with painful interphalangeal joints.
Lastly, thumb arthritis should not be treated with conventional or biological antirheumatic drugs, which may modify the condition.
Thumb arthritis: treatment with surgery
Surgery is only performed in patients with structural abnormalities or when other thumb arthritis treatments have been insufficient to reduce pain. Trapeziectomy is used in patients affected by arthritis at the base of the thumb and arthrodesis or arthroplasty are preferred in patients with interphalangeal arthritis.
*These products are class I medical devices that bear the CE marking under this regulation. Carefully read the instructions before use. Manufacturer: Millet Innovation. 12/2021
For more details about this general and simplified approach, here are further sources:
(1)Zhang, W, M Doherty, B F Leeb, L Alekseeva, N K Arden, J W Bijlsma, F Dincer, et al. 05/2007 « EULAR Evidence Based Recommendations for the Management of Hand Osteoarthritis: Report of a Task Force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT) ». Annals of the Rheumatic Diseases 66 (3): 377 88.
(2)Kloppenburg, Margreet, Féline PB Kroon, Francisco J Blanco, Michael Doherty, Krysia S Dziedzic, Elsie Greibrokk, Ida K Haugen, et al. 05/2019 « 2018 Update of the EULAR Recommendations for the Management of Hand Osteoarthritis ». Annals of the Rheumatic Diseases 78 (1): 16 24
(3)Hochberg, Marc C., Roy D. Altman, Karine Toupin April, Maria Benkhalti, Gordon Guyatt, Jessie McGowan, Tanveer Towheed, Vivian Welch, George Wells, et Peter Tugwell. 05/2012 « American College of Rheumatology 2012 Recommendations for the Use of Nonpharmacologic and Pharmacologic Therapies in Osteoarthritis of the Hand, Hip, and Knee ». Arthritis Care & Research 64 (4): 465 74. 05/2012 110 15.