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What is Thumb Basal Joint Arthritis?
Thumb Basal Joint Arthritis (Rhizarthrosis) is osteoarthritis of the carpometacarpal (CMC) joint of the thumb. It is one of the most common hand arthropathies, affecting up to 15% of women and 7% of men over 50 years old. The thumb participates in 40% of all hand functions, so its involvement critically reduces quality of life.
Traditional surgical treatment — trapezium removal or joint replacement — requires prolonged rehabilitation and does not always restore grip strength.
Symptoms:
- Pain at the base of the thumb during grasping and pinching
- Weak grip — difficulty opening jars, turning keys
- Swelling and deformity in the anatomical snuffbox area
- Crepitus with movement
- Limited thumb abduction
Stages (Eaton-Littler Classification):
- I — joint space narrowing, minimal changes
- II — osteophytes, joint space narrowing less than 2 mm
- III — marked osteophytes, subluxation, cysts
- IV — involvement of adjacent STT joint
Facts about Thumb Basal Joint Arthritis
- ICD-10: M18.1
- Prevalence: 15% of women over 50
- Gender: women affected 2 times more often
- Thumb function: 40% of hand functions
- Surgery: rehabilitation 3-6 months
Thumb base osteoarthritis (rhizarthrosis): treatment options and what is known about them
The treatment plan is made by the clinic doctor after an examination and a review of your images. The table shows the options usually discussed for this diagnosis and how well they have been studied.
| Option | What to expect | How well studied |
|---|---|---|
| Braces, splints, insoles | Offload and stabilise, reduce pain under load | Moderate evidence |
| Exercise therapy and physiotherapy | Reduces pain, strengthens muscles, improves function; the basis of treatment | Moderate evidence |
| Painkillers and NSAIDs | Ease pain during flare-ups; long-term use is limited by side effects | Moderate evidence |
| Corticosteroid injection | Quickly reduces inflammation and pain, the effect is often temporary; frequent injections are undesirable | Limited or conflicting evidence |
| Hyaluronic acid | Reduces pain for a few months in some patients | Limited or conflicting evidence |
| PRP / CGF | Concentrate from your own blood; may reduce pain, growth of new tissue has not been shown | Limited or conflicting evidence |
| Joint arthroplasty or fusion | If conservative treatment does not help or there is an indication | When indicated — the doctor decides |
We send your request to several partner clinics. Some will suggest conservative treatment or injections, others surgery; each clinic quotes its own conditions and price. We help you compare the options.
Regenerative methods: realistic expectations
In osteoarthritis, regenerative injections can reduce pain and improve function for a period of several months to a year. PRP in knee osteoarthritis is the best studied: in a number of trials it reduced pain more than hyaluronic acid, but not in all of them. Restoration of damaged cartilage has not been shown. Cell-based methods (BMAC, MFAT) are less well studied and more expensive. Exercise and weight control remain the basis of treatment — injections add to them rather than replace them.
When surgery is discussed. Surgery is discussed when marked pain and restricted movement do not improve after 3–6 months of conservative treatment, and in advanced stages with deformity.
If an injection helps, the effect usually builds up over 6–12 weeks, and the result is assessed after 2–3 months. No clinic can guarantee a result.
Good to know: diagnosis, self-help, outlook
How to tell thumb base arthritis from similar conditions
In thumb base (CMC) arthritis pain occurs at the base of the thumb when pinching, opening jars or turning a key; over time the joint thickens and becomes deformed. De Quervain’s tenosynovitis hurts higher up along the thumb side of the wrist, and carpal tunnel syndrome causes numb fingers rather than pain on gripping. A hand X-ray confirms the diagnosis and sets the Eaton stage.
What you can do yourself
Use aids with thick handles and jar openers and avoid prolonged pinching. A thumb splint at night and during activity reduces pain. Exercises for the thumb base and hand muscles and heat for stiffness — after advice from a hand therapist.
Outlook and timelines
Thumb base arthritis progresses slowly; a splint, exercise and pain relief help most patients for years. A corticosteroid injection reduces pain for weeks to months. With marked pain and deformity when treatment fails, surgery is discussed — removal of the trapezium bone or a joint replacement.
Who it is not suitable for and possible risks
Contraindications
- Active infection — at the injection site or systemic, with fever.
- Active cancer or ongoing chemotherapy.
- Blood clotting disorders or a low platelet count. Anticoagulants are discussed with the physician.
- Pregnancy and breastfeeding — the procedure is usually postponed.
- A corticosteroid injection into the same area in recent weeks.
- A complete tendon or ligament rupture with loss of function — surgical repair is usually needed.
Possible risks
- Pain and swelling at the injection site for 1–3 days.
- Bruising where blood or fat tissue is taken.
- Rarely, infection. The procedure is therefore performed under sterile conditions with ultrasound or X-ray guidance.
- The effect may be absent or smaller than expected.
If any of these apply to you, mention it in your request. The coordinator will check with the clinic physician whether treatment is possible. Contact a coordinator.
Scientific evidence
Studies of regenerative methods show mixed results. Clinic physicians rely on research including the following:
- Catapano M et al. Effectiveness of Platelet-Rich Plasma Injections for Nonsurgical Management of Carpal Tunnel Syndrome: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Arch Phys Med Rehabil, 2020.
- Sheth U et al. Efficacy of autologous platelet-rich plasma use for orthopaedic indications: a meta-analysis. J Bone Joint Surg Am, 2012.
Next steps: Treatment methods · Treatment cost · How treatment in Germany is organised
Frequently Asked Questions about Treatment of Thumb Basal Joint Arthritis (Rhizarthrosis)
RegenPAS is a patient service centre in Munich, not a clinic. We review your images and symptoms and send a request to several partner clinics at once. Clinics that can accept you send their own conditions and price; prices differ between clinics, and you choose the option that suits you. The coordinator replies within 24 hours, and a clinic physician’s preliminary opinion follows in 1–3 business days. We then arrange the appointment, visa invitation, interpreter, transfers and accommodation. Treatment decisions are made by the clinic physician. Contact a coordinator.
Your MRI (or CT, X-ray) report and the images if you have them, plus a short description of your symptoms and previous treatment. Send them via the form on the website — the assessment is free and without obligation: the coordinator replies within 24 hours, and the clinic physician’s preliminary opinion follows in 1–3 business days.
The cost depends on the method, the diagnostics needed and the clinic itself: prices differ between clinics. We request offers from several clinics and send you their conditions and quotes so you can compare. Price guidance is on the treatment cost page. For an outpatient procedure, 2–3 days in Munich are usually enough: examination, procedure and follow-up visit.
Clinic and method matching — free of charge
Describe your case and attach your MRI report. We will identify clinics that use the relevant methods and forward your request to them. No obligation; we reply within 24 hours.
Send a request