Managing Thumb Osteoarthritis: A Physiotherapist's Guide to Reducing Pain and Improving Mobility

Osteoarthritis (OA) of the thumb, also known as basal joint arthritis, is a common condition that affects the joint at the base of the thumb (the carpometacarpal or CMC joint). This type of arthritis can cause significant pain and stiffness, making it challenging to perform everyday activities like gripping objects, turning keys, or opening jars.

As a physiotherapist, I’ve worked with many patients who experience thumb OA, and while the condition can’t be cured, there are effective ways to manage the symptoms and improve function. In this post, I’ll outline some practical strategies to help you reduce pain, regain strength, and maintain mobility.

Understanding Thumb OA

Thumb osteoarthritis occurs when the cartilage that cushions the ends of the bones in the CMC joint begins to wear down, causing the bones to rub against each other. This results in pain, swelling, and a decrease in range of motion. Risk factors for thumb OA include:

• Age: It’s more common as we get older.

• Gender: Women are more likely to develop it.

• Previous Injuries: Trauma to the thumb, such as a fracture or sprain, can increase the risk.

• Repetitive Stress: Activities that require heavy use of the thumb joint, like knitting, typing, or manual labor, can exacerbate symptoms.

Managing Thumb OA Pain: Physiotherapy Tips

While OA can’t be reversed, adopting some simple lifestyle changes and incorporating specific exercises can significantly ease your symptoms and improve your quality of life.

1. Activity Modification

Reducing strain on the thumb joint is one of the first steps to managing OA pain. Here are a few ways to modify your daily activities to lessen the pressure on your CMC joint:

• Use Larger Grips: Replace small-handled utensils or tools with larger, ergonomic handles that are easier to grip without pinching your thumb.

• Two-Handed Techniques: Use both hands to carry heavy objects or open containers instead of relying on your thumb alone.

• Limit Repetitive Movements: Avoid activities that require excessive pinching or twisting of the thumb, like turning a key or unscrewing tight lids. Using adaptive devices can help ease these tasks.

2. Thumb Braces for Support

Wearing a thumb brace or splint can help support the CMC joint, reduce pain, and prevent further damage. There are different types of braces available:

• Resting Splints: Worn during sleep to keep the thumb joint in a neutral position.

• Functional Braces: Provide support during activity without restricting movement.

Your physiotherapist can recommend the appropriate brace based on your needs and daily routine. Wearing a brace regularly, especially during flare-ups or while performing activities that stress the joint, can make a big difference in managing pain.

3. Cold and Heat Therapy

• Cold Therapy: Applying an ice pack to the base of the thumb for 10-15 minutes can help reduce inflammation and numb pain after activity.

• Heat Therapy: Using a warm compress or soaking your hand in warm water can improve blood circulation and relax the muscles, making it easier to perform exercises.

Both cold and heat therapy can be used as needed, depending on your symptoms. Generally, cold is best for reducing swelling after activity, while heat is ideal for loosening up stiff joints before exercise or daily activities.

4. Thumb Stretches and Exercises

Strengthening the muscles around the thumb joint can help reduce strain on the CMC joint and improve stability. Here are some simple exercises you can perform at home:

• Thumb Stretch: Hold your hand out in front of you with your palm facing up. Gently stretch your thumb away from your fingers, holding the position for 5-10 seconds. Repeat 10 times.

• Thumb Opposition: Touch the tip of your thumb to the tip of each finger, one at a time, forming a circle with each pair. Repeat this movement 10 times on each hand to improve coordination and flexibility.

• Isometric Thumb Press: Place the thumb of your affected hand against the base of the fingers of your opposite hand. Press your thumb gently into the other hand, creating a light resistance. Hold for 5 seconds, then relax. Repeat 10 times.

• Grip Strengthening: Use a soft ball or stress ball to squeeze with your entire hand. Hold the squeeze for 5 seconds before releasing. This exercise helps strengthen the muscles in your thumb and hand, which can improve grip strength.

It's important to perform these exercises slowly and gently, avoiding any movements that cause pain or discomfort. As you gain strength, you can gradually increase the intensity of the exercises.

5. Joint Protection Techniques

Learning how to protect your joints during daily activities can help minimize wear and tear on the CMC joint. Some helpful techniques include:

• Use Assistive Devices: Tools like jar openers, ergonomic pens, or button hooks can reduce the need to strain your thumb.

• Distribute Pressure: When carrying objects, spread the load across your entire hand rather than using just your thumb.

• Avoid Excessive Gripping: Try to avoid holding objects tightly for extended periods, as this can increase pain and inflammation.

When to Seek Professional Help

If your thumb OA symptoms continue to worsen despite these self-care measures, or if pain significantly limits your daily activities, it may be time to seek professional help. A physiotherapist can create a personalized treatment plan that includes:

• Manual Therapy: Techniques to mobilize the CMC joint, improve its range of motion, and reduce stiffness.

• Advanced Exercises: Strengthening and stretching exercises tailored to your specific condition and activity level.

• Ultrasound or Laser Therapy: These treatments can help reduce pain and inflammation in more severe cases.

In some cases, a referral to a hand specialist or an orthopedic surgeon may be necessary to discuss more invasive options, such as corticosteroid injections or even surgery.

Living with Thumb Osteoarthritis

Thumb osteoarthritis can be frustrating, but with the right combination of lifestyle changes, exercises, and professional care, you can manage your symptoms and continue to enjoy your daily activities. Remember, the key to managing OA is consistency. Regularly practicing the exercises, protecting your joints, and modifying your activities will go a long way in preserving your thumb's function and reducing pain.

If you're struggling with thumb OA, consider reaching out to a physiotherapist for a personalized treatment plan to help you get back to living your life with less pain and more mobility. Often OA thumb is best treated in a clinic where they tend to more modalities to treat your thumb pain, if you need some clinics in the local mid Cornwall area let us know and we can put in touch with someone.

Physio@Home is proud to offer specialized physiotherapy services across mid Cornwall, from Truro to Falmouth, including villages like Feock, Playing Place, Mabe, Carnon Downs, Penryn, and Mawnan Smith. Our care also extends northward to St Agnes and Perranporth, as well as to surrounding communities like Perranarworthal, Chacewater, Devoran, and Constantine. No matter where you are, we are committed to delivering high-quality, personalized physiotherapy directly to your community.

More information

Osteoarthritis Information Booklet - by Versus Arthritis