Patient Education · davidweimd.com
A patient guide to arthritis at the base of the thumb — causes, symptoms, and treatment options from Dr. David H. Wei, MD, MS.
Download the full PDF handout to review at home or share with a family member.
What This Condition Is
Thumb CMC arthritis is wear-and-tear arthritis at the small joint where the thumb meets the wrist. This joint lets your thumb pinch, grip, open jars, turn keys, and hold objects.
When the smooth cartilage in the joint wears down, the bones can rub together — causing pain, swelling, weakness, stiffness, and a sense that the thumb is not as strong or stable as it used to be.
Key takeaway: You do not need surgery just because an X-ray shows arthritis. Treatment is based on your pain, function, goals, and response to simpler options.
Common Symptoms
Pain at the base of the thumb, especially with pinching or gripping.
Difficulty opening jars, turning doorknobs, using keys, writing, cooking, gardening, or holding a phone.
Weak pinch or grip, swelling, tenderness, stiffness, or a bump near the base of the thumb.
Why It Happens
Thumb CMC arthritis usually develops gradually over time and is often considered a primary form of arthritis — there may not be one single injury or event that caused it.
Age, genetics, prior injury, joint looseness, and long-term thumb demands can all play a role. Symptoms vary widely between patients.
How It Is Diagnosed
Diagnosis is usually made with your story, a focused hand exam, and X-rays. The exam looks for tenderness at the base of the thumb, pain with pressure across the joint, stiffness, weakness, and nearby problems that can mimic or worsen thumb pain.
Non-Surgical Treatment
Bracing
A thumb CMC brace can support the base of the thumb and reduce painful motion during daily activities.
Hand therapy
Therapy can improve mechanics, strengthen supportive muscles, and teach joint-protection strategies.
Medication
Anti-inflammatory medication, acetaminophen, or topical anti-inflammatory gel may help when safe for you.
Cortisone injection
A steroid injection may reduce pain and inflammation. Relief varies and is not a cure for arthritis.
Surgical Options
There is no single best surgery for every patient. The right operation depends on your arthritis pattern, thumb stability, bone quality, activity demands, and goals.
Surgery may be reasonable when pain continues despite bracing, therapy, activity changes, medication, or injections — and when symptoms interfere with daily life, work, hobbies, sleep, or independence.
Trapeziectomy / LRTI — The most common operation in the United States. Removes the arthritic trapezium bone, often with ligament reconstruction and tendon interposition.
Thumb CMC joint replacement — In selected patients, a joint replacement may be an option. An implant replaces the worn joint surfaces instead of relying on soft-tissue support alone.
Other options — Fusion, denervation, or other procedures may be considered in specific situations.
What to Expect
Non-surgical care can often reduce symptoms and help you manage activities. If surgery is chosen, recovery usually involves a period of protection, gradual motion, hand therapy, and progressive strengthening. Improvement after thumb arthritis surgery continues for months.
Your surgeon will review the expected timeline based on the specific procedure recommended for you.
Ready to Discuss Your Options?
Schedule an evaluation with Dr. Wei
Book at ONS ↗© 2026 David H. Wei, MD, MS · This guide is for patient education and is not a substitute for personalized medical advice.