Thumb osteoarthritis: definition & progression



Definition and progression of thumb osteoarthritis

Intense thumb pain makes you think of osteoarthritis ? Maybe you’re suffering from thumb osteoarthritis . This thumb condition is frequent, especially in women over 50 years old. Its severity progresses over time through several stages. Focus on this disabling process in the daily life.

 

The thumb: a complex joint

Thumb osteoarthritis is sometimes referred to as rhizarthrosis or osteoarthritis affecting the trapeziometacarpal joint . The base of the thumb, close to the wrist, is composed of a set of bones that are articulated to each other. These bones are the scaphoid, trapezium and first metacarpal bone, which is in contact with the trapezium bone. It makes a multidirectional joint . It allows large rotational movements of the thumb (circumduction).

Progressively, the movements damage the cartilages of this joint and make motion painful. This cartilage wear often affects both hands.

 

Thumb osteoarthritis : painful wear of the thumb joint

The affected areas are different according to people: if the wear concerns the joint between the wrist bone (trapezium) and the first metacarpal (base of the thumb), we talk about trapeziometacarpal osteoarthritis . If the wear concerns the joint between the two wrist bones; the scaphoid and trapezium, we talk about scaphotrapeziotrapezoid osteoarthritis .

When the condition worsens, there is a loss of grip strength between the thumb and forefinger. Pain intensifies and the thumb progressively deforms into a Z-shape, or M-shape in some cases. Then, pain reduces and is replaced by joint stiffness. This progression is very slow and spreads over 10 years(1).

By examining the symptoms of thumb osteoarthritis , you will be able to identify the warning signs and to limit the progression of the condition.

 

Worsening of thumb osteoarthritis in 4 stages

The different stages of this condition have been classified by several theorists(2, 3, 4).

Here, we focus on the Dell classification that determines 4 stages of thumb osteoarthritis (2).

• First stage corresponds to joint space narrowing without subluxation (movement of bones in the joint ) or osteophytes (formation of a bony spur near the joint ).

• Second stage involves slight subluxation that can still be treated and early stage osteophytosis.

• Third stage refers to osteophytosis with significant joint space narrowing and advanced stage subluxation.

• Fourth and last stage consists of complete destruction of the joint space, with prominent osteophytes, geodes (cysts) and ankylosis of the trapeziometacarpal joint .

 

Solutions to relieve thumb osteoarthritis

The worsening of thumb osteoarthritis is not a fatality! Indeed, many solutions, from the simplest to the most radical, allow you to stop the progression of the condition. Some are preventive, some are curative and aim to relieve the pain associated with thumb osteoarthritis , and others are used to limit the deformity.

EPITACT® has developed protections to relieve pain of thumb osteoarthritis and to limit its progression.

The thumb brace for night* aims to limit pain for more peaceful nights. Also, the flexible thumb brace for activities* allows to relieve pain and helps to correct inappropriate movements intuitively.

 

*These products are class I medical devices that bear the CE marking under this regulation. Carefully read the instructions before use. Manufacturer: Millet Innovation. 09/2021

 

For more details about this general and simplified approach, here are further sources:

(1)Delcambre B, Bera-Louville A, Guyot-Drouot MH. Osteoarthritis of the fingers and trapeziometacarpal joints. Joint Bone Spine 2001;68:339–47.

(2)Dell PC, Brushart Tm, Smith RJ. Treatment of trapeziometacarpal arthritis : results of resection arthroplasty. J Hand Surg 1978;3:243–9.

(3)Eaton RG, Glickel SZ. Trapeziometacarpal osteoarthrosis staging as a rationale for treatment of trapezo metacarpal osteoarthrosis. Hands Clinics 1987;3:455–69.

(4)Comtet JJ, Gazarian A, Fockens W. Definition and classification of basal joint osteoarthritis . A critical analysis and proposals. Treatment options. Chir Main. 1 févr 2001;20(1):5‑10.

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