Thumb Arthritis (CMC Joint): Causes, Treatment & Surgery Options in Phoenix

If opening jars, turning keys, or pinching small objects has become painful, you may be dealing with arthritis at the base of your thumb. The carpometacarpal (CMC) joint—where the thumb meets the wrist—is one of the most common locations for arthritis in the hand, particularly in women over 50.

As a hand surgeon in Phoenix, I see thumb basal joint arthritis almost daily. The good news is there are excellent treatment options at every stage of the disease.

What Is Thumb CMC Arthritis?

The CMC joint sits at the very base of your thumb, where the first metacarpal bone meets the trapezium bone in the wrist. This joint is shaped like two saddles interlocking, which gives the thumb its remarkable range of motion—but also makes it vulnerable to wear-and-tear arthritis. Over time, the cartilage cushioning this joint wears away, leading to bone-on-bone contact, pain, weakness, and eventually deformity.

Who Gets Thumb Arthritis?

• Women are 10–20 times more likely than men to develop symptomatic CMC arthritis

• Age over 50, though it can occur earlier after trauma

• Prior fracture or injury to the thumb or wrist

• Joint hypermobility (loose ligaments)

• Family history of arthritis

• Occupations or hobbies involving repetitive pinching and gripping
  

Symptoms

• Pain at the base of the thumb, worsened by pinching, gripping, or twisting

• Swelling and tenderness at the thumb base

• Weakness when pinching—difficulty opening jars, turning keys, or holding small objects

• A grinding sensation (crepitus) with thumb movement

• In advanced stages, a visible bump or deformity at the thumb base as the joint subluxes
  

Non-Surgical Treatment

Many patients manage well for years with conservative treatment:

Splinting

A thumb spica splint supports the CMC joint and reduces stress on the arthritic surfaces. Wearing it during aggravating activities or at night can significantly reduce pain.

Anti-Inflammatory Medications

Oral NSAIDs and topical anti-inflammatory creams can help manage flares.

Corticosteroid Injection

An injection of corticosteroid directly into the CMC joint can provide weeks to months of relief. This is both therapeutic and diagnostic—if the injection relieves your pain, it confirms the CMC joint as the source.

Activity Modification

Ergonomic tools, jar openers, key turners, and other adaptive devices can reduce stress on the joint during daily activities.

When Is Surgery Needed?

Surgery is considered when pain and functional limitation persist despite conservative measures. The most commonly performed and reliable procedure is:

Trapeziectomy with Ligament Reconstruction

This involves removing the trapezium bone (the worn-out arthritic bone) and reconstructing the supporting ligaments using a nearby tendon. This eliminates the bone-on-bone contact while maintaining thumb length and stability. The procedure has a long track record of excellent outcomes with high patient satisfaction.

Other options include CMC joint fusion (arthrodesis) for younger, high-demand patients, and various implant arthroplasties. I discuss all options and recommend the best approach based on your age, activity level, and disease severity.

Recovery After Thumb Arthritis Surgery

• Weeks 1–2: Splint or cast immobilization, keep hand elevated

• Weeks 2–6: Transition to a removable thumb spica splint, begin gentle motion with hand therapy

• Weeks 6–12: Progressive strengthening, gradual return to activities

• Months 3–6: Continued strength gains. Most patients report significant pain relief and improved function by 3 months, with full recovery by 6 months
  

Frequently Asked Questions

Can thumb arthritis be prevented?

There is no proven way to prevent CMC arthritis, as genetics and joint structure play a major role. However, avoiding excessive repetitive stress and using ergonomic tools may help delay symptoms.

Is thumb arthritis the same as rheumatoid arthritis?

No. CMC arthritis is osteoarthritis (wear-and-tear). Rheumatoid arthritis is an autoimmune condition that affects joints differently. Both can affect the hand, and both are conditions I treat.

How strong will my thumb be after surgery?

Most patients regain excellent pinch and grip strength after recovery. Many patients report their thumb feels stronger than before surgery because they’re no longer guarding against pain.

Thumb Arthritis Care Across the Valley

If thumb pain is limiting your daily activities, you don’t have to live with it. I provide comprehensive evaluation and treatment for thumb arthritis for patients across the Phoenix metro—Scottsdale, Mesa, Chandler, Gilbert, Fountain Hills, Peoria, Goodyear, and Buckeye. ☎ Schedule Your Consultation

Call (602) 258-4788 or visit toddrichardsmd.com to book an appointment with Dr. Todd Richards. Most insurance plans accepted. Same-week appointments often available.