Pain at the base of the thumb from arthritis is due to loss of cartilage in the joint between the thumb and the wrist (1st carpo-metacarpal joint). It occurs more commonly in women and may affect either dominant or non-dominant hand, or both). Pain is typically  experienced in ‘grip and twist’ motion.

I find that most patients don’t want to use a splint to rest the hand as the splints are cumbersome. Nor do they want to take regular painkillers. I do sometimes advise a short course of anti-inflammatories if there is a flare up of the arthritis (if the patient  is allowed to take anti-inflammatories).

An injection of a steroid into the diseased joint can be very effective with the majority of my patients getting 6 to 12 month’s relief of pain.

If the steroid injection is not working, and if the pain is severe, affecting activities on a daily basis then surgery may be indicated. This involves a general anaesthetic as a day-case. Through an incision on the side of the wrist a small bone (the trapezium)  is removed and the space filled with a length of tendon, which also stabilises the thumb. Recovery is slow but I know the operation is effective as many patients return after 1 to 2 years to have the other side done.