The thumb is a joint unique to the human hand. Its joint complex allows for it to be opposable. Opposable means it is capable of being moved freely and independently. The freely moveable joint allows for “flexion and extension, abduction and adduction. It also allows medial and lateral rotation around a third axis; however, these motions cannot be actively isolated. They must be coupled with flexion and extension, respectively.”
Really, this means the wide range of motion of thumbs help humans have second-to-none fine motor skills and other skillful hand movements. However, the varied abilities and use of our thumbs can make the thumb joints susceptible to overuse.
What is the CMC Joint?
The thumb’s Carpalmetacarpal joint (CMC joint) is the joint at the base of the thumb.
The CMC joint has a shape that is unique to the thumb, the saddle joint, and allows for the thumb’s large range of motion and function.
Pain is very common in this joint due to the biomechanical demands on the thumb. For this reason, individuals with excessive repetitive stress on the thumb joint are more susceptible to CMC joint pain.
What causes hand CMC joint arthritis?
Thumb pain in the CMC joint is a type of degenerative osteoarthritis. In this joint, repetitive motion where the thumb meets the wrist wears down the cartilage in the joint. When the cartilage in the joint becomes unhealthy or wears away, it can become very painful to use the joint. The exact nature of the pain should be diagnosed by a physician since the cause of the arthritis can be due to lifestyle, age, genetics, or other inflammatory conditions.
What are the symptoms of CMC joint arthritis?
Usually, the first symptom of CMC joint arthritis is pain in the joint. Other signs include redness in the area of the thumb joint, stiffness and mobility issues, and swelling. A progressed sign of CMC joint arthritis is when a patient has trouble grasping objects due to pain and a lack of strength. Some patients also develop a prominence and thickening of the joint, creating a bony appearance at the base of the thumb.
What is the treatment for CMC joint arthritis?
Regenexx Tampa Bay physicians evaluate the severity of the CMC joint arthritis by performing an orthopedic evaluation analyzing the joint and muscles, as well as by using a diagnostic ultrasound to visualize the health of the surrounding tissues and the joint.
When a CMC joint warrants regenerative medicine, a Regenex Tampa Bay physician may use Platelet Rich Plasma (PRP) or Bone Marrow Concentrate (BMAC)—either plasma from the blood, or bone marrow concentrate extracted from the patient’s bone.
A recent study evaluating the efficacy of BMAC in the treatment of CMC joint arthritis may augment the standard of care when treating osteoarthritis in the thumb joint. In the study, twenty-seven subjects with moderate to severe osteoarthritis of the CMC joint were treated with BMAC.
The BMAC procedure was analogous to those performed at Regenexx Tampa Bay at New Regeneration Orthopedics:
- The bone marrow was extracted from the iliac crest
- A specialized centrifuge and lab processing procedure was used to concentrate the BMAC cells
- The pathological joint was injected under fluoroscopic or live x-ray guidance
The patient results were assessed at 16 months post-procedure. The patients completed a series of pain and function tests and surveys. The average results from these test demonstrated over 18 degrees of gained thumb range of motion as well as a 43% decrease in pain.
The majority of the patients reported significant improvement in quality of life and pain relief. Only two patients (7%) in this sample went on to need thumb surgery within the 16 months post-procedure. No patients reported complications after their procedures.
This study is a compelling first step at evaluating the efficacy of regenerative medicine in the treatment of moderate to severe osteoarthritis in the CMC joint. In terms of the standard of care, your Regenexx physician might suggest BMAC as the gold-standard for CMC joint arthritis, especially before considering surgery.
Regenexx Tampa Bay at New Regeneration Orthopedics physicians will help guide you through choosing the best option for your thumb pain. Tell us about yourself, and we’ll be in touch.