Thumb arthritis or Rhizarthrosis

Is a pain at the base of the thumb and is due to degenerative changes (wear of the joint)

Figure 1. Healthy hand

Figure 2. Hand with mild arthritis

 
 

How common is rhizarthrosis or thumb arthritis?

It’s the second most common type of arthritis of the hand, after interphalangeal arthritis (arthritis of the fingers). Rhizarthrosis affects around 12% of men and about 21.2% of women above the age of 55. This illness can cause strain on day-to-day activities as it limits movement in the hand.

Why do people get rhizarthrosis or thumb arthritis?

The thumb joint is very flexible and in constant movement because it allows the hand to perform multiple activities such as gripping and holding. However, what causes rhizarthrosis is that when the ligaments are relaxed there’s a friction between the first metacarpal and the trapezium. Furthermore, ligaments can get so relaxed that a dissociation between the trapezium joint and the metacarpal is lost (sprain or dislocation).

Figure 3. Hand with severe arthritis

What are the symptoms?

The symptoms can be felt at the base of the thumb and can range from a mild, sporadic discomfort to a strong, disabling pain. The pain will increase with regular activity, mainly with gripping and holding movements such as using scissors and opening jars and doors, but its should decrease as long as the hand is not in use.

What are the treatment options for rhizarthrosis or thumb arthritis?

Treatment will depend on how advanced the illness is.

– In the initial stages your doctor will contain the illness by using splints, thermotherapy (ice packs and heating pads), physical therapy and medication for pain or swelling.

Treatment for initial stage rhizarthrosis

Using a brace

The intention of the brace is to help reposition the bones and give support which has was lost because of the relaxation of the ligaments.

Figura 4. Pathological change of rhizarthrosis

Infiltration

This involves injecting a painkiller and anti-inflammatory medication directly into the joint. Infiltration will help mainly with managing pain and reducing it temporarily.

Physical therapy

Therapy is an essential tool that will help stabilize the joint, along with the brace, it’s very important to have strong muscles that help support and stabilize the joint. The main muscles to work on are the dorsal interossei and the opponens pollicis.

Figura 6. Primera interóseo dorsal

Figure 5. Opponens pollicis muscle.

 

Who’s an ideal candidate for a rhizarthrosis operation?

An ideal candidate would be a patient with whom non surgical options have failed or those in which rhizarthrosis was diagnosed at an advanced stage and the doctor has no other option but to operate.

The surgical procedure depends, not only on the advanced stage in which the illness is at, but also the day-to-day activities of each patient, regardless of the procedure needed the aim of the surgery is to reduce pain without compromising the proper functioning of the thumb.

Open surgical option

Wrist Arthroscopy Option

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