The CMC joint (carpometacarpal joint) is a saddle joint that allows us to grip, oppose, and manipulate objects with our hands. The CMC joint is not responsible for weight bearing (like your knees or hip), but can still be affected by arthritic changes. Research shows that as many as 15% of adults over 30 suffer from arthritic changes in the CMC joint. Our thumb is under a lot of stress from griping, carrying, and repetitive motions. With these repetitive motions the joint can get very unstable, weak, and therefore will be prone to injury.
Signs and Symptoms:
Pain with gripping and pinching
Pain turning a key or a doorknob
Dull, Achy pain even at rest – in later stages
Medications, injections and surgery are all available options. Surgery varies depending on the extent of damage and can involve reconstructing the thumb using pieces of your wrist flexor tendons, arthroplasty (replacement of the entire joint), or arthrodesis (fusing the bones together). Your surgeon will discuss your options if you meet the requirements for that type of intervention. Recovery involves approximately 4 weeks of thumb casting/splinting (no movement) to allow the surgical site to heal and is always followed up with physical therapy to stretch, strengthen and return you to normal function. Typical recovery is 2-3 months; while maintaining a good HEP/home strengthening program for at least 1-2 years (depending on surgery) for full strength to return.
The BEST conservative treatment is splinting and physical therapy. Physical Therapy involves gentle stretching, range of motion exercises and gradual strengthening to promote healthy, functional movements by increasing circulation, range of motion, and endurance. Physical therapy will also review hand and upper body ergonomics to ensure proper placement and use of your hand during activities that might induce extra strain on your thumb and its supporting ligaments. Splinting is available to help position your hand and thumb in a resting position to allow for healing throughout the day and/or night.
Our office specializes in the treatment of hands and fingers; we are located in Clermont and Ocoee, Florida.