Osteoarthritis of the thumb

The base of your thumb is where the metacarpal bone of the thumb meets the trapezium, a small carpal bone in your wrist. This joint is called the carpometacarpal joint, or CMC for short and it is commonly affected by osteoarthritis.

The CMC joint is very reliant on the ligaments surrounding the thumb joint and on the shape of the bones to stabilise the thumb when you are pinching or grasping around an object. Over time, the stability of the thumb may be affected by changes to the ligaments and bone surfaces, changing the way that the joint moves and causing problems with everyday tasks.


You may experience the following symptoms:

  • Pain at the bottom of the thumb, which can worsen with use.
  • Tenderness if you press the bottom of the thumb joint.
  • Difficulty carrying out everyday tasks such as opening a jar or using a key.
  • Over time, a bony lump may appear at the base of the thumb. You may find it gets more difficult to open the thumb to span an object. In later disease, the thumb may adopt a more zig-zag type shape.

You may be referred for an X-ray, which may show that you have arthritis at the base of your thumb, or into your wrist joint. Many people with arthritis on X-ray however, do not experience significant pain.


You can help manage your symptoms using the self-management strategies listed below.  Self-management focuses on the following:

Pain relief

Medication (such as simple painkillers or anti-inflammatories) may be useful. A pharmacist or your GP can help advise you what to take if needed. You can find further information here on what medications you could take here:



Ice or heat therapy

You may find heat helpful to ease stiff and painful joints. Try filling a bowl with warm water or resting your hand on a microwaved heat pack for 10 minutes. Do not use heat if your joint is hot and swollen as it may make it worse. Instead you can consider using an ice pack or bag of frozen peas.

Place a tea towel on your wrist (to protect your skin from ice burns), and then place an ice pack or bag of frozen peas over the painful area. Leave this on for ten minutes and use up to 3 times per day.

  • Please be cautious using ice if you have altered sensation or circulatory problems.
  • Check the skin regularly, and stop if there is excessive pain or tingling.

Hand Exercises

Hand exercises can be beneficial to improve range of movement, prevent stiffness and strengthen the muscles acting around the base of the thumb.

Versus Arthritis have some useful information on osteoarthritis of the hand and wrist, as well as a home exercise programme. This can be found here:

Osteoarthritis of the hand and wrist (versusarthritis.org)

If your symptoms are not improving with self-management, a hand therapist can help you better manage your symptoms through a tailored exercise and management programme. Hand therapists can be accessed via the NHS following a referral from your healthcare practitioner (or privately).

You can follow the link here to the British Association of Hand Therapists for more detail.

The British Association of Hand Therapists (hand-therapy.co.uk)


You might find a thumb splint is useful to support you when carrying out heavier activities. You can find such splints online, or seek help from a hand therapist (an occupational therapist or physiotherapist, who specialises in managing hand conditions).

Do not wear it all the time though, as you may find your joints feel stiffer.

Joint Protection

Joint protection techniques can help you to better manage your symptoms. Some  useful tips are listed here.

Remember the four P’s of Joint protection!


  • Identify and avoid the activities that are causing pain. Avoiding activities that strain your joints, or changing the way you carry out activities that may help to reduce the pain you are experiencing.
  • Avoid tight grips or gripping for long periods of time. Gripping or pinching tightly requires greater force which can increase your pain levels and cause stress to your joints.
  • Activities such as vacuuming or window cleaning mean that you are doing the same movements lots of times. Try and do these activities for shorter periods or get some help from someone.
  • Rearrange your work areas so that everything you need is within easy reach. Reorganise things you use regularly into easy to open containers.


  • Respect pain. If pain continues for a few hours after you have completed an activity, this means that the activity was too much (or you should have stopped sooner). Try and better balance your everyday activities so that you do not overuse your joints and aggravate your pain.
  • Look at pacing your activities across the week, so that you do not aggravate your joints. Balance activity and rest. Manage day to day tasks “little and often” rather than all in one go.


  • Use your joints in a good, stable position. Avoid activities that could lead to, or worsen deformities (such as twisting, pushing or pulling movements which put pressure onto the joints).
  • Use larger, stronger joints rather than smaller ones, or spread the load, using two hands rather than one (for example, when tipping water from a pan).


  • Use gadgets/small aids to reduce the strain on your joints. There are a wide range of small gadgets that you can use to help you around the home that can take the pressure and load off your joints (for example, an electric can opener). This will help you to protect your joints in the longer term.

Examples of useful items can be found here:

Kitchen aids

  • Oxo good grips have a range of items with large handles, such as a Y shaped potato peeler/masher.
  • Use a kitchen aid, such as a one touch can opener, Jarkey or Strongboy jar opener to help you when opening jars and cans, to reduce stress on your joints.
  • Use stainless steel baskets in your saucepans, to help you drain your vegetables more easily.
  • Use a kitchen aid, such as a Mini Chopper to help you chop vegetables instead of doing it by hand. You could buy ready chopped or use frozen vegetables as an alternative.
  • Using an angled knife helps you to avoid stress on your thumb joint when cutting meat or bread.


If your symptoms persist, you may be referred for an assessment with a hand surgeon. They may consider a steroid injection into the joint, which can help reduce pain in the short term (although the effect usually wears off over time).

Sometimes surgery can help- but usually this is a last resort, as symptoms can often be controlled by following the self-management techniques described above. A hand surgeon will advise you as to what surgery would be the best for your symptoms.  Please follow the link below to the BSSH site for more information.

Basal thumb arthritis | The British Society for Surgery of the Hand (bssh.ac.uk)

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