Nerve Damage

Carpometacarpal Joint (CMCJ) Arthrosis

Carpometacarpal joint arthrosis (CMCJ arthrosis), refers to osteoarthritis which develops at the base of the thumb. Osteoarthritis is the most common form of arthritis and the thumb is one of the most common locations. Arthrosis at the base of the thumb goes by several names including basilar thumb joint arthrosis, trapezoid-metacarpal arthrosis, degenerative joint disease, and various other terms.

Joint arthrosis at a glance:

• Carpometacarpal joint arthrosis refers to osteoarthritis that occurs at the base of the thumb.
• CMCJ arthrosis usually develops over time due to wear and tear on the thumb joint.
• Symptoms include pain and swelling at the base of the thumb.
• CMCJ arthrosis can usually be successfully treated with nonsurgical methods, but joint replacement may be necessary in severe cases.

What causes CMCJ arthrosis?

Carpometacarpal joint arthrosis is very common and there are many causes. Approximately 50 percent of woman over the age of 50 and approximately 75 percent of all individuals over the age of 65 can develop CMCJ arthrosis.

The thumb joint undergoes a lot of strain from wear and tear. Pinching and grasping activities can literally wear out the joint over the course of a lifetime. The joint surface becomes damaged and can wear down completely, causing the bones to rub together. Prior injuries such as sprains and fractures can accelerate this wear and tear.

CMCJ arthrosis frequently develops in postmenopausal women for unknown reasons.

CMCJ Symptoms

Symptoms of CMCJ include:

• Pain and swelling at the base of the thumb
• Bone spurs that give the thumb a squared-off appearance
• Swelling
• Instability in the joint that can lead to dislocation

In severe cases of instability, the thumb can be contracted into the palm of the hand, making it difficult to grasp items. This combination of changes results in painful grasp and pinch which can severely compromise daily activities.

CMCJ Treatment

Carpometacarpal joint arthrosis is a common disorder. Unfortunately, there are no significant preventative measures available, and treatment is dependent upon the extent and severity of the existing symptoms.

Treatment for CMCJ may include:

• Over-the-counter medication such as aspirin or Tylenol
• Limiting physical activity
• Rest, ice, and elevation
• Custom splits to stabilize the base of the thumb joint while allowing full motion in the wrist
• Cortisone injections
• Thumb joint replacement surgery in severe cases

Be sure to talk to your pharmacist before purchasing anti-inflammatories as these medications may be contraindicated as they may interact with other medications and medical conditions.

CMCJ Treatment Outcomes

Many patients can resume virtually all their normal activities while undergoing treatment. Medication, splinting and cortisone injections can provide significant benefit without the need for surgery. Although the arthrosis can progress, this does not necessarily mean that pain will progress.

The outcome following surgery is highly dependent upon individual circumstances. In general, most patients have significant benefit with respect to their pain, but there can be approximately a 20-30 percent permanent loss of motion and grip strength. The outcome regarding individual circumstances can be further discussed with your physician.