Hand and Wrist Arthritis


Thumb Arthritis is one of the most common arthritis problems found in the hand and wrist.  The use of Platelet Rich Plasma offers a revolutionary new way to treat this common problem.

Thumb Arthritis

basilar thumb oa

Arhtritis, or osteoarthritis (OA) of the thumb is one of the most common arthritis problems.  It is the second most common form of arthritis in our body.  Knee arthritis is more common.  The hand and thumb are obviously critically important.  The thumb has to be pain-free, mobile, and stable to work properly for us.  The joint that is commonly affected is call the thumb carpo-metacarpal joint (CMC joint), or basilar joint of the thumb.  Therefore another name for this problem is Thumb CMC OA.  

Thumb CMC OA occurs because of a variety of factors.  The most common is the development of instability at this joint, which over time causes the joint to wear out prematurely.  This causes pain.  Pain is then worsened because the nerves in the area get irritated as well.  

In order to properly treat this problem effectively all of these problems need to be addressed.  The joint needs to be stabilized, the inflammation in the joint reduced, the weakened cartilage rejuvenated, and the nerve irritation reduced.  

Traditional treatment has not appropriately addressed these issues.

The Normal Thumb

The thumb is a complex and important part of our body.  It allows us to hold and manipulate things that only we as humans can do.  The thumb depends on the joint at the base of the thumb to work properly.  This joint has to be mobile, stable, and pain free to be effective for us.  

Some people develop more “free play” or instability of the basilar joint of the thumb than others, and these people are more predisposed to developing arthritis in this joint.  When arthritis does develop, the pain and dysfunction creates problems in how well the thumb and hand can be used.

Thumb Arthritis (Thumb CMC OA)

The most common joint of the hand to develop arthritis is at the base of the thumb.  This joint is called the basilar joint of the thumb or the thumb CMC (carpometacarpal) joint. This joint is important for the function of the thumb.  When arthritis develops here it can cause pain at the base of the thumb and the “meaty” part of the palm (thenar eminence), the pain is worse with pinching and grasping, often the joint “slips out of place” to some degree, and sometimes the nerve in the wrist can get irritated and cause worse pain.   

The thumb CarpoMetaCarpal (CMC) joint is the most commonly affected with arthritis in the hand.

The Problem With Traditional Treatment of Thumb Arthritis

Traditional treatment option for Thumb CMC arthritis include rest, splinting, ice/heat, physical therapy, use of oral NSAIDS, corticosteroid injection, and surgery.

Rest, splinting, local measures such as heat and ice, and physical therapy are certainly worthwhile to do.  Sometimes the symptoms can resolve quickly with these simple techniques.  If symptoms persist additional treatment may be necessary.  It is important to realize what the implications of some of these additional treatments can be, since they may not be that effective and have significant negative effects on the thumb.

thumb-pain-grey red

NSAIDS (non-steroidal anti-inflammatory drugs) are taken by month and reduce inflammation.  This can help with some of the pain, but often is not that helpful since this medication is taken systemically and only a very small amount ends up in the area of the thumb.  The problem is that NSAIDS are associated with some very significant negative effects: ulcers, bleeding, stroke, heart attacks.  That is not a good trade-off.  Also NSAIDS are knows to reduce and inhibit the natural healing process.

Corticosteroids are often injected in this area to treat the thumb CMC arthritis.  Corticosteroids block the inflammation process.  The problem is that inflammation is part of our natural healing process.  Additionally corticosteroids injected in this area weaken ligaments and cause additional instability, cause atrophy or breakdown of fat and skin, and cause softening and damage to the joint cartilage.  So, corticosteroid injections in this area can actually ultimately make the problem worse.  It can temporarily relieve some of the pain, but will cause the problem to worsen.  Rather than helping, these medication produce effects that are completely opposite of what the area really needs to heal.

thumb cmc arthroplasty

The surgery that is typically done involves removing part of the joint and bone, and using a wrist tendon to try and stabilize the base of thumb.  This surgery is VERY invasive and it takes a long time to recover from it.  The base of thumb is markedly changed with this surgery, and function is never normal again.  It would be ideal to avoid doing this surgery.  Other options could include using a metal or plastic joint replacement, but these are associatedwith even more significant problems.

Surgery for arthritis at the base of thumb can sometimes ultimately be necessary, but if the area could be treated properly and effective in another way - that is allowing the joint to become more stable, stimulate healing, reducing inflammation, and providing factors that can help strengthen the cartilage - this would certainly be much more beneficial.  This is where the use of Regenerative Medicine and appropriate Platelet Rich Plasma can be very effective.

Stem Cell and Platelet Rich Plasma (PRP) Treatment for Thumb Arthritis

Platelet Rich Plasma (PRP) is an autologous biological therapy that can effectively all aspects of Thumbs CMC Arthritis.

The various bioactive substances in Platelet Rich Plasma treat thumb arthritis in the following ways:

thumb cmc injection blue background

PRP injection into the Base of the Thumb can effectively treat Thumb CMC OA.

   -  stabilize the unstable joints by tightening the ligaments that make the joint stable

   -  reduce inflammation and pain in the joint

   -  increase hyaluronic acid secretion to help lubricate the joint

   -  inhibit the breaking down of cartilage (catabolic processes)

   -  stimulate the building up of cartilage (anabolic processes)

   -  reduce irration of the nerves around the wrist to decrease pain

Platelet Rich Plasma treatment for thumb arthritis has some very distinct advantages.  The treatment is safe and uses products from your own body.  The treatment addresses all the problems, allows the body to heal naturally, and maintains the structures of the wrist intact.  The procedure is done in the office and you can return home right away on your own.  There is no downtime involved with this treatment, and it is not associated with all the typical complications of “traditional” treatments.  If necessary the PRP Injection can be repeated as needed.  

The Platelet Rich Plasma that is used to treat Thumb Arhtritis needs to be specifically prepared depending on what area is being treated, be it the ligaments, nerve, or the joint.  All PRP is not the same and needs to customized accordingly.

The Regenerative Medicine and Joint Preservation Center of Santa Rosa makes this revolutionary treatment option available to the physician and their patients that are suffering from Thumb Arthritis.

Call us at (707) 978-4322 to talk about your problem and see what we can do for you.

thumb pinching claw

Regenerative Injection Therapy with Platelet Rich Plasma for your wrist can get you back to what you love doing.

©         Regenerative Medicine and Joint Preservation Center of Santa Rosa    2017