What is Arthrosis of the First CMC Joint?

The thumb is essential for almost everything we do with our hands. It allows us to grip, hold, and handle a wide range of everyday tasks with ease. But when the base of the thumb starts to ache or feels stiff, it can have a big impact on daily life. One common cause of this is arthrosis of the first carpometacarpal (CMC) joint, often called thumb arthritis. This condition happens when the cartilage cushioning the bones at the base of the thumb begins to break down. As a result, pain, swelling, and limited movement can make simple actions like opening jars or turning keys much harder. Understanding this condition is the first step towards managing it effectively.

What is Arthrosis of the First CMC Joint?

Arthrosis of the first CMC joint is a type of osteoarthritis that affects the joint where the thumb meets the wrist. This joint, also known as the trapeziometacarpal joint, is special because it lets the thumb move in many different directions, including touching the other fingers. Its unique biconcave shape gives it great flexibility, but it also makes the joint more prone to wear and tear. Over time, the smooth cartilage that cushions the bones starts to break down, causing the bones to grind against each other. This rubbing leads to pain, swelling, and makes it harder to use the thumb properly.

Causes and Risk Factors

The main cause of arthrosis in this joint is natural aging. Cartilage wears down gradually, and the thumb joint faces constant stress from activities like pinching, gripping, and twisting. This stress can weaken the ligaments that stabilise the joint, leading to instability and faster cartilage breakdown. Other risk factors include:

• Being female, especially after menopause
  
• Age over 40 years
  
• Obesity
  
• Hereditary conditions such as joint laxity or malformed joints
  
• Previous injuries to the thumb, like fractures or sprains
  
• Diseases affecting cartilage, such as rheumatoid arthritis
  
• Occupations or hobbies that put repeated stress on the thumb
  
  

Symptoms of Arthrosis of the First CMC Joint

Symptoms often start with pain at the base of the thumb. This pain is usually worse during gripping or pinching movements. You may also notice swelling, stiffness, and tenderness around the joint. Over time, the condition can cause your thumb to lose strength. This makes it harder to hold objects firmly. The range of motion may reduce, and the joint can appear enlarged or develop bony lumps called bone spurs. These symptoms can make everyday activities like opening jars, turning doorknobs, sewing, or gardening painful or hard to perform. Additionally, many people with this condition also develop carpal tunnel syndrome.

Common symptoms include:

• Pain at the base of the thumb during gripping or pinching
  
• Swelling, stiffness, and tenderness around the joint
  
• Reduced thumb strength and difficulty holding objects
  
• Decreased thumb movement
  
• Enlarged or bony appearance of the joint
  
  

How is It Diagnosed?

A healthcare professional will start the diagnosis by carefully examining your thumb’s movement, strength, and any swelling present. Because thumb pain can be caused by several conditions, your doctor will rule out other problems such as DeQuervain’s tenosynovitis, trigger thumb, or arthritis in other thumb joints. X-rays are often used to confirm the diagnosis and show the extent of cartilage loss, joint space narrowing, and bone spur growth.

Treatment Options

Treatment options for arthrosis of the first CMC joint range from simple rest and splinting to medications and, in severe cases, surgery. Choosing the right approach depends on the severity of symptoms and how much they affect daily life.

Non-Surgical Treatments

Most people start with conservative care. Resting the thumb and avoiding painful activities can help reduce inflammation. Splints or braces are commonly used to support and immobilise the joint. These range from custom-made splints to off-the-shelf options for milder cases. Pain and swelling can be managed with non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen. Physical or hand therapy helps strengthen muscles around the joint, improving stability and reducing stress on the joint.

Also read : What is Tendovaginitis

Surgical Treatments

If symptoms are severe and do not improve with non-surgical care, surgery may be considered. Surgical options include removing damaged joint tissue, repairing ligaments, or replacing the joint entirely. Surgery aims to relieve pain and restore function. Recovery usually involves a period of immobilisation followed by rehabilitation exercises.

Common treatments include:

• Rest and activity changes to reduce joint stress
  
• Thumb splints or braces to immobilise and support
  
• NSAIDs to control pain and inflammation
  
• Hand therapy to strengthen and increase flexibility
  
• Surgery for advanced cases

Recommended Supports for Arthrosis of the First CMC Joint

For managing arthrosis of the first CMC joint, using a supportive thumb splint can greatly reduce pain and improve function. Consider ergonomic thumb spica splints or solid thumb support braces that stabilise the joint while allowing comfortable movement. Wrist braces designed for related wrist pain can also provide additional relief. These products help protect the joint during daily activities and promote healing by limiting harmful motions. Always choose a splint that fits well and suits your level of activity to get the best results.

Living with Arthrosis of the First CMC Joint

Managing this condition daily can be challenging, but there are ways to ease symptoms. It is important to rest the thumb when it hurts and use tools designed to reduce strain, such as jar openers or ergonomic grips. Early treatment and consistent management can slow joint damage and help you maintain your quality of life.

When to See a Doctor

You should consult a doctor if pain, swelling, or stiffness at the base of your thumb lasts for several weeks or worsens. Also, seek medical advice if your thumb becomes weak, deformed, or if daily tasks become difficult due to pain. Early diagnosis is important to prevent further joint damage and to find the right treatment.

Conclusion

Arthrosis of the first CMC joint is a common source of thumb pain, especially as people age. It can cause significant discomfort and interfere with everyday activities. Fortunately, many people manage their symptoms well with early treatment and lifestyle changes. If you suspect you have thumb arthritis, speaking with a healthcare professional will help you get an accurate diagnosis and appropriate care. Taking action early can keep your thumb strong and functional for years to come.