Comprehensive Guide to Carpometacarpal Arthritis: Symptoms, Causes, and Treatments

Carpometacarpal (CMC) arthritis is a condition that primarily affects the base of the thumb, which connects to the wrist at the carpometacarpal joint. This joint is critical in enabling the thumb’s wide range of movements, such as gripping, pinching, and rotating. It is essential for everyday tasks like opening jars, writing, or using a smartphone. 

Over time, wear and tear or repeated stress on this joint can lead to the deterioration of cartilage—the smooth tissue that cushions bones and facilitates joint movement. When the cartilage wears away, the bones may rub against each other, causing pain & swelling.

This condition is one of the most common forms of osteoarthritis in the hand, particularly affecting individuals over 50 or those with a history of repetitive hand movements. It can make simple tasks difficult and, if untreated, may lead to deformity or significant loss of function in the thumb. Let’s delve deeper into carpometacarpal arthritis, its causes, symptoms, and treatment options.

Symptoms of Carpometacarpal Arthritis

• Pain: Most noticeable at the base of the thumb, worsening with activities involving pinching or gripping
• Swelling and Tenderness: Around the joint, which may vary in intensity
• Weakness: Reduced ability to grasp or pinch objects
• Stiffness: Difficulty moving the thumb, especially after rest
• Deformity: A noticeable bump or change in the shape of the thumb joint over time
• Grinding Sensation (Crepitus): A feeling or sound of bones rubbing together during movement
• Loss of Motion: Difficulty performing movements requiring the thumb to extend or rotate

Causes and Risk Factors of Carpometacarpal Arthritis

Carpometacarpal arthritis, or thumb arthritis, results from cartilage deterioration at the base of the thumb joint. The loss of this protective tissue leads to increased friction and joint damage, causing pain and limited function. The following details explain the underlying causes and key risk factors:

• Aging and Wear-and-Tear: Over time, the cartilage in joints naturally degenerates due to everyday use. This process, often associated with aging, is a leading cause of carpometacarpal arthritis. The thumb joint is particularly susceptible due to its frequent and complex movements.
• Repetitive Stress or Overuse: Frequent thumb use for tasks requiring pinching, gripping, or twisting—such as writing, knitting, or opening jars—can accelerate cartilage wear. Individuals with hobbies or jobs involving these repetitive movements are at higher risk.
• Previous Injuries: Past trauma, such as a fracture, sprain, or dislocation near the thumb joint, can weaken the cartilage or alter joint mechanics, increasing the likelihood of arthritis in that area.
• Joint Instability: Weak ligaments or structural imbalances in the thumb joint can cause abnormal stress and uneven cartilage wear over time, contributing to arthritis development.
• Inflammatory or Metabolic Conditions: Conditions like rheumatoid arthritis, which involves chronic joint inflammation, or gout, which results in uric acid crystal buildup, can also damage the thumb joint, leading to secondary carpometacarpal arthritis.

Risk Factors for Carpometacarpal Arthritis

• Age: Individuals over 50 are more prone to carpometacarpal arthritis due to the cumulative effect of joint usage and cartilage degeneration.
• Gender: Women are at a higher risk, particularly postmenopausal women. Hormonal changes may impact cartilage health and joint stability, making women more susceptible.
• Genetic Predisposition: A family history of osteoarthritis or joint issues can increase a person's likelihood of developing this condition. Genetic factors may influence the quality of cartilage and joint structure.
• Lifestyle and Occupation: Jobs requiring repetitive thumb movements or constant hand use—like carpentry, hairstyling, or typing—expose individuals to higher risks. Similarly, specific hobbies, such as playing musical instruments or knitting, can contribute to joint strain.
• Obesity: While the thumb joint does not bear weight directly, obesity contributes to systemic inflammation and stresses overall joint health, which may exacerbate arthritis symptoms.
• Other Medical Conditions: People with conditions like Ehlers-Danlos syndrome or lupus, which affect connective tissues, may be more vulnerable to joint instability and arthritis.

Diagnosing Carpometacarpal Arthritis

Medical History

• The doctor begins by asking about symptoms, such as pain, stiffness, or difficulty with thumb movements.
• Information on daily activities, previous injuries, or family history of arthritis helps identify contributing factors.

Physical Examination

• The physician examines the thumb and surrounding area for signs of swelling, tenderness, or deformities.
• Joint motion and stability are evaluated by asking the patient to perform movements like gripping or pinching.
• Specific tests, like the “grind test,” may assess pain and detect grinding sensations when the thumb joint is gently rotated.

Imaging Tests

• X-rays are the primary imaging tool for identifying joint changes, such as bone spurs, joint space narrowing, or bone misalignment.
• MRI or CT Scans: In some cases, advanced imaging may be recommended to assess cartilage loss or rule out other conditions.

Differential Diagnosis

• To ensure an accurate diagnosis, the doctor may evaluate for other conditions that mimic carpometacarpal arthritis, such as tendonitis or ligament injuries.

Treatment Options for Carpometacarpal Arthritis

Managing carpometacarpal arthritis focuses on reducing pain, preserving thumb function, and improving quality of life. Treatment options might vary based on the severity of the condition and can range from non-invasive approaches to surgical intervention.

Non-Surgical Treatments

• Activity Modification: Avoiding activities that strain the thumb joint excessively can help minimize symptoms. Ergonomic tools or techniques may reduce stress during daily tasks.
• Thumb Splints or Braces: Wearing a splint or brace stabilizes the thumb joint, reduces movement, and allows the joint to rest, decreasing pain and inflammation. Splints are particularly helpful during flare-ups or while performing specific tasks.
• Physical Therapy: A physical therapist may design a program of exercises to improve thumb strength, flexibility, and stability. Gentle stretching and strengthening exercises can reduce stiffness and enhance joint support.
• Heat and Cold Therapy: Heat can relax the joint and improve blood flow, while cold therapy helps to reduce swelling & pain. Alternating between the two may provide better symptom relief.
• Lifestyle Adjustments: Maintaining a healthy weight can lower systemic inflammation and reduce stress on joints. In addition, hand-friendly practices, like using assistive devices to open jars, can ease the burden on the thumb joint.

Medications

Your doctor may recommend some over-the-counter or prescription medications based on your symptoms. These should always be taken under medical supervision to ensure safety and effectiveness.

Surgical Treatments

If non-surgical methods do not provide relief and the condition significantly affects daily life, surgery may be considered. Depending on the extent of joint damage, procedures range from joint reconstruction to joint fusion or replacement.

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Sterling Hospital has proven itself to provide the best orthopedic hospital in Ahmedabad, Vadodara, and Rajkot. We provide you with the utmost care and comfort throughout your journey to healthy bones and joints. If you are looking for the best orthopedic doctor in Ahmedabad, Vadodara, Rajkot and Gandhidham,  we've got you. Safeguard your bone health and contact Sterling Hospital to schedule a consultation and embark on a journey towards a healthier life.