Treating Carpometacarpal Arthritis

A painful thumb can truly limit the ability to perform activities and in fact limit hand function by 45%

CMC arthritis is a common condition seen by our therapists in the clinic. It can be characterised by pain and aching around the base of the thumb which may radiate down the thumb or up the forearm, tenderness over the CMC joint and stiffness in the thumb in the morning or after inactivity. Pain and aggravation is usually most intense during tip pinch, palmar pinch, lateral pinch and prolonged grasp.
We constantly encounter high forces through this joint on a daily basis so our therapy includes education on joint protection. Joint protection involves analysing tasks that clients complete on a daily basis to modify and adapt how they complete these activities to reduce excessive loading on joints. This education includes; avoiding pain during activities, distributing load over several joints by using stronger, larger joints, using joints in their most stable and functional positions, reduce effort, maintain ROM, balance activity and rest, avoid twisting forces and avoid staying in one position for long periods/static grips. Therapists use the below treatment hierarchy when discussing options for intervention with clients in the clinic.

We constantly encounter high forces through this joint on a daily basis so our therapy includes education on joint protection. Joint protection involves analysing tasks that clients complete on a daily basis to modify and adapt how they complete these activities to reduce excessive loading on joints. This education includes; avoiding pain during activities, distributing load over several joints by using stronger, larger joints, using joints in their most stable and functional positions, reduce effort, maintain ROM, balance activity and rest, avoid twisting forces and avoid staying in one position for long periods/static grips. Therapists use the below treatment hierarchy when discussing options for intervention with clients in the clinic.

We discuss compensatory techniques and show examples of assistive equipment clients can use in the household/work to participate in activities that cause aggravation. A common intervention used in therapy is the provision of custom made and pre-fabricated splints. Our therapists can fabricate tailored splints to fit each individual in the clinic. Splinting aims to enhance pain-free use of the thumb and allow individuals to partake in previously aggravating activities without pain.
Clients with advanced disease who have failed conservative treatment do have multiple surgical options including ligament reconstruction, resection arthroplasty, silicone implantation, tendon interposition or total joint arthroplasty. Our therapists provide splinting, scar management and specific exercise programs post surgery to gradually improve grip strength, grasp and regain functional use of the hand. If you would like further information on what our therapists provide for conservative and post-op management of CMC arthritis please contact the clinic to discuss with one of our therapists.

We all use our hands in different ways so it is important to us that we look at each individual carefully, tailoring therapy to their individual characteristics, needs and lifestyles