When your thumb is hurting, swollen or weak, it doesn’t take long to realize how much you depend on it. Suddenly, your grip isn’t strong enough to open a pickle jar. And when you try to turn a doorknob, it increases the pain in your hand.

You may wonder why your thumb hurts and what you can do about it. There are different causes of hand and thumb joint pain, but arthritis is a common reason – especially as you get older. The most common location of thumb arthritis is in the joint at the base of your thumb. This joint is called the basal joint or the carpometacarpal (CMC) joint of the thumb, which is why thumb arthritis is often referred to as basal joint arthritis or CMC arthritis.

Basal thumb arthritis causes soreness and swelling in your thumb joint

Arthritis refers to pain, and often swelling, in your joints. Joints are the places where your bones connect together and move. You have about 350 joints in your body, and you can have arthritis in any of them. However, it’s most common in the hands, hips and knees.

Many people get basal joint arthritis as they get older – estimates say that it affects 30-50% of people over the age of 50. Symptoms can be so mild that it doesn’t have to be treated. But thumb arthritis can also be severe enough that surgery is recommended to help with the symptoms.

The most common location of thumb arthritis is in the joint at the base of your thumb. This joint is called the basal joint or the carpometacarpal (CMC) joint of the thumb, which is why thumb arthritis is often referred to as basal joint arthritis or CMC arthritis.

Osteoarthritis is the most common type of thumb arthritis

Osteoarthritis is common with aging and happens when the cartilage wears away from the ends of the bones that form a joint. When joints are healthy, the cartilage protects and cushions your bones as they glide over each other. After decades of use, it’s natural for the cartilage to start to wear down and become thin or rough in places. Without the protective cartilage between them, bones can rub against each other, damaging the joint and causing inflammation and pain. Over time, osteoarthritis can lead to bone spurs and bone thickening. Some of these bone growths can become large enough to change the shape of your hand.

Osteoarthritis usually starts slowly and gets worse over time. But it’s possible for post-traumatic arthritis to develop after a fall, car accident or sports-related hand injury that caused a bone fracture or dislocation. This type of osteoarthritis is more common in younger people.

Rheumatoid arthritis can also affect your thumb

You can also have rheumatoid arthritis in your thumbs, but this type of arthritis is more likely to affect your other fingers first. Also, it usually affects the joints on both sides of the body at the same time, so you’d likely have arthritis in both thumbs.

Rheumatoid arthritis is an autoimmune disease, which means that your immune system doesn’t work properly and attacks healthy tissues in your joints. Over time, rheumatoid arthritis can lead to thinning bones and deformed joints. It can also affect other body systems, including your skin, eyes, lungs, heart and blood vessels.

Thumb arthritis symptoms to watch for: Swelling, stiffness and pain at base of thumb

The main symptoms of thumb arthritis are soreness, swelling and stiffness. Specific symptoms may include:

  • Joint pain – Your thumb joint pain may be mild or severe, or your thumb may feel warm and tender.
  • Stiffness – It may be hard to move your fingers, especially in the mornings.
  • Swelling – The base of your thumb may look swollen.
  • Reduced strength and limited range of motion – Your symptoms are likely to get worse when pinching or grasping objects, making it difficult to do everyday tasks like opening jars, turning knobs or zipping up a sweatshirt.
  • Changes in appearance – Your thumb may look enlarged, especially bony or like your thumb is “out of joint.”

Causes of thumb arthritis include aging or injury

Thumb arthritis becomes more common as you get older and the cartilage in your joints starts to wear down, but it can also follow trauma or injury.

Risk factors for thumb arthritis

There are several reasons why you may be more likely to get thumb arthritis, including:

  • Being a female (or assigned female at birth)
  • Age of 40 years or older
  • Being very overweight
  • Hereditary conditions that affect joint stability or structure
  • Jobs or activities that require repetitive motions or forceful gripping
  • Previous thumb injury

Thumb arthritis diagnosis starts with a physical exam

It’s worth seeing a hand specialist or primary care doctor if you have swelling, stiffness or pain at the base of your thumb that doesn’t go away. Both doctors can help diagnose the cause of hand pain and recommend treatments to manage your symptoms.

During your appointment, the doctor will ask about your symptoms, when and where you feel pain, and past injuries to your hand. Your doctor will check for swelling, changes in your hand’s appearance and other causes of thumb pain. For example, people with thumb arthritis sometimes have carpal tunnel syndrome, so your doctor may check for that as well.

In order to understand the stage of your thumb arthritis, your doctor may recommend thumb arthritis tests such as X-rays or other imaging to check for bone spurs, cartilage loss or changes in joint space.

Thumb arthritis treatments can relieve thumb joint pain

Working with a hand specialist or primary care doctor is the best way to get a treatment plan to manage your symptoms. Your treatment will depend on your symptoms and stage of basal thumb arthritis, but it typically begins with a combination of a thumb brace, medications, home remedies and hand therapy.

Medications

A good place to start is often with nonsteroidal anti-inflammatory drugs (NSAIDs) you apply to the skin (topical medications) or take by mouth (oral medications).

  • Topical medications – Topical medications are often recommended for arthritis because they can provide relief to specific areas. Plus, they don’t go through your digestive system, so you may be able to avoid the stomach problems caused by some oral medications. Many options are available without a prescription. Look for creams and gels that include diclofenac (Voltaren, Aspercreme), capsaicin (Capzasin-HP, Zostrix) or salcylate (Aspercreme, Bengay).
  • Oral medications – You may be able to get temporary relief from pain and swelling by using common medications such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin IB), naproxen sodium (Aleve) and aspirin. However, long-term use of these medications can sometimes cause stomach ulcers and gastric bleeding. Plus, some NSAIDs can increase your risk of heart attack and stroke, so talk to your doctor about whether they’re the best choice for managing your thumb arthritis symptoms.
  • Prescription medications – It’s also possible that your doctor may recommend prescription pain relievers.

Hot or cold therapy

Hot and cold therapy can be helpful in reducing inflammation, stiffness and pain from basal joint arthritis. Cold therapy works for most people, but some find heat is more effective. Trying both will help you figure out what works best for you.

  • Cold therapy – Cold temperatures reduce swelling and blood flow to an area, causing numbness. To use cold therapy, wrap a cold pack and hold it against your thumb or soak your hands in ice water for 5-10 minutes at least twice a day. Cold therapy is often a good choice when arthritis flares up.
  • Heat therapy – Heat opens up your vessels, increasing blood flow to an area. This can reduce the chance of muscle spasms and help with stiff joints. You can apply heat therapy in various ways, such as a wrapped heating pad, soaking your hands in warm water or applying a warm washcloth to your thumb. Try applying heat for 15 minutes at a time throughout the day. Heat therapy can be especially helpful before exercise.

Adaptive equipment for thumb arthritis

You can buy different adaptive tools and aids that make it easier to complete everyday activities if you have weakness or pain in your thumb when gripping.

Adaptive tools for thumb arthritis are designed to reduce stress on your thumb, especially during grasping motions. Common adaptive equipment for thumb arthritis includes jar openers, easy-grip utensils, book holders, tap turners and large zipper pulls. If you’re not sure which tools to get, a hand therapist can provide recommendations.

Splints and braces for thumb arthritis

Your hand specialist may recommend that you wear a splint at night or during certain activities. Removable splints and braces for arthritis in the thumb can help in different ways:

  • Make your hand work better – A soft splint can help hold your thumb in the correct position so it’s less painful to do everyday tasks.
  • Rest your thumb – Wearing a rigid custom-made splint limits hand motions. This gives your thumb time to rest and can decrease inflammation and pain.

Hand therapy and thumb exercises for arthritis

Exercising your hands can help improve joint flexibility and reduce stiffness so your thumbs (and the rest of your hands) work better. They can also help improve the stability of your thumb. But not all exercises are appropriate. For example, you’ll want to avoid gripping and pinching exercises, since these motions can make thumb arthritis worse. It’s also important to stop doing exercises if they’re painful.

A hand therapist can recommend the best exercises for you, but they may include:

  • Moving your thumb up and down – Gently move your affected thumb up and down.
  • Making the “okay” sign – Start with the fingers and thumb of your affected hand pointing straight up. Touch your thumb to each finger, one at a time. The fingers that aren’t touching should remain straight up. Do 10 sets and then repeat on the other hand, even if you don’t have arthritis in both thumbs.
  • Massage in warm water – If you have stiffness in the morning, it may be helpful to gently move your thumb while your hand is in warm water.

Corticosteroid injections

If home remedies and medications don’t provide relief, your doctor may recommend an injection. Corticosteroid injections can offer temporary pain relief and reduce inflammation, making it easier to move your thumb and perform everyday tasks. Injections start working almost immediately and help with symptoms for several months. But there are some risks, especially with repeat injections, so there’s usually a limit to the number you can have.

Thumb arthritis surgery

Surgery may be a good option if your thumb pain doesn’t get better with other treatments. Depending on your situation, the surgeon may recommend surgery to fuse or replace the joint.

When to get a helping hand for your thumb pain

If you have persistent swelling, stiffness or pain at the base of your thumb, make an appointment with a hand specialist. These are experts who specialize in diagnosing conditions that can affect your hand. Plus, you don’t need a referral.

You can also start by talking to your primary care doctor about your symptoms. If necessary, they’ll refer you to a specialist for advanced care.