Pain in the thumb often indicates thumb saddle joint osteoarthritis – medically referred to as rhizarthrosis. It causes pain and hinders gripping and holding movements of the thumb and thus the hand. Our specialists in hand orthopaedics at ATOS Clinics offer a whole package of proven and successful therapies for rhizarthrosis.
The term rhizarthrosis comes from the Greek “rhiza”, which means “root”. It refers to arthritis of the thumb saddle joint and is one of the most common signs of wear of the joints of the hand. Abrasion of the protective cartilage layer in the joint creates additional friction that causes painful inflammation and swelling. Ultimately bone rubs on bone, and the joint is destroyed.
The thumb saddle joint is one of the most stressed joints in humans and is greatly strained by the large number of sometimes very strong gripping and holding movements. For artisans such as tilers or plumbers, rhizarthrosis is considered an occupational disease. It is a hereditary condition, occurring in women more often than in men.
The severity of the pain depends on the stage of osteoarthritis and varies within an astonishing range. There are patients who do not complain of pain even with severe arthrosis, but also patients who already experience severe pain with mild osteoarthritis. In addition, pain often occurs only after heavy strain on the thumb.
Diagnosis of thumb saddle joint arthrosis begins with a medical history report and medical examination. It is confirmed by x-rays. An examination for a possible diagnosis must be carried out with additional feelings of numbness.
There is no drug therapy for the restoration of cartilage; therefore, the main goals of a treatment are pain relief and mobility preservation. With conservative therapies such as a thumb splint, ice treatment, medication or electrotherapy, the symptoms can be alleviated. This can also be achieved through acupuncture, injections of hyaluronic acid and mixed corticoid injections.
In the event of persistent symptoms, the pain and restrictions of movement can be permanently removed by various surgical therapies:
With a denervation, the pain-transmitting nerve fibres are interrupted. However, this operation only works for a few years as the nerve fibres regrow.
With so-called resection arthroplasty, the arthritic parts of the carpal bone are removed and replaced by tendon surgery for improved stability.
Fusion operation (arthrodesis)
In younger patients or artisans, a fusion operation (arthrodesis) is often preferred, which offers the advantage of strong resilience of the joint at the expense of fusing the thumb joint.
Rehabilitation – Time and methods
After the thumb joint osteoarthritis surgery, the thumb is immobilised for about 2 weeks. In some cases, the immobilisation must be extended to 4-6 weeks. After removal the sutures and with good wound healing careful load increase can be started under the guidance of a physiotherapist.