Thumb arthritis is the most common arthritis of the hand and wrist, affecting the joint at the base of the thumb – also known as the carpometacarpal or CMC joint. In many cases, people often ask about a cortisone injection in thumb joint. So, what is thumb arthritis, and when should you have a cortisone shot?
What are the symptoms of thumb arthritis?
Thumb arthritis usually causes pain, swelling, and stiffness at the base of the thumb. Pain is worse when gripping, pinching, or grasping. People often find it difficult to perform simple tasks such as opening jars or turning doorknobs or keys. Also, other findings include restriction in movement of the thumb, decreased thumb strength, and a bony appearance at the base of the thumb.
Factors that can increase the risk of thumb arthritis include female sex, age over 50 years, previous injuries such as cracks or sprains of the thumb, jobs that place high stress on the thumb, and obesity.
How do we diagnose thumb arthritis?
Often, we diagnose thumb arthritis using a combination of clinical tests and X-rays.
In general, clinical findings include tenderness at the base of the thumb, restricted movement of the thumb joint, and reduced thumb strength.
X-ray of the thumb shows narrowed joint space, spur formation, and a deformed joint.
Overall, it is essential to assess every patient with thumb pain to ensure no other cause such as De Quervain’s tenosynovitis, trigger thumb, or inflammatory arthritis.
What treatments are available for thumb arthritis?
Generally, most people respond well to simple treatments supervised by a hand therapist. These treatments include specific stretching and strengthening exercises for the thumb, wrist, and forearm. Sometimes, a hand therapist can try manual therapy techniques to improve thumb movement. For example, a thumb spica splint can help reduce pain by limiting the movement of the thumb while still allowing the use of the thumb.
Pain-relieving creams or gels such as ibuprofen or flexiseq can help with exercise therapy.
Should you have a cortisone injection in thumb joint?
In cases that fail to respond to simple treatments, steroid injection for basal thumb arthritis is the next step. In addition, you should consider a cortisone injection for thumb when your pain is severe, or your thumb arthritis stops you from performing simple activities such as dressing, cooking, or cleaning.
Recent evidence suggests that ultrasound-guided injections for thumb arthritis are more accurate and effective than blind injections. Specifically for the CMC joint injection, ultrasound-guided injections are 94% accurate compared to 80% with blind injections. In addition, cortisone injections for thumb provide good pain relief for up to 6 months.
What about gel injections for thumb arthritis?
Some doctors think that gel injection is also helpful for thumb arthritis., although we need more evidence to support this view. Gel injections also known as hyaluronic acid injections are used for arthritis. However, a recent paper suggests no favorites regarding 1st CMC joint injection.
What about PRP injection for thumb arthritis?
Although a PRP injection has shown a good effect on knee arthritis, there is no evidence that PRP helps thumb arthritis. Nevertheless, we would think about a PRP injection for thumb arthritis in people who have failed other treatments including a cortisone injection.
If a CMC joint injection is not effective, we would then consider a surgical procedure of fusion or bone excision.
Final word from Sportdoctorlondon about a cortisone injection in thumb
Thumb arthritis is a common condition associated with pain with simple activities and restriction in thumb movement. Simple treatments such as hand therapy and splints can help. An ultrasound-guided cortisone injection in the thumb joint can also assist. You should find a doctor with experience in injecting under ultrasound.
I am suffering from a flare up of the base of both thumbs and it has been with me for some time. I do not think it is going to go away anytime soon, so I am maybe looking for relief in the way of having cortisone injections to relieve the pain, can you help me please?
yes I think a cortisone injection is a good option. About 80% of patients feel relief after a cortisone injection. I’d suggest, however, you do these injections under ultrasound to improve accuracy.
Lorenzo
What does having a cortisone injection in thumb joint under ultrasound mean please
It means using ultrasound to guided the needle into the right spot of arthritis at the base of the thumb.
I have received two rounds of these shots. The last round lasted almost 8 months and I just recently received the second round. It is a game changer. I highly recommend it if you have thumb arthritis.
I had a cortisone injection in each of my thumbs, plus two in my right wrist. Not done with ultrasound. They were all very painful, but the ones in my thumbs were horrendous. As in scream/yelling at the top of my voice awful.It would take a lot of convincing to do that again. That was yesterday, so don’t know yet how helpful they’ll be.
Hi Sandra, Unfortunately, thumb injections are notorious for being painful. Generally, having injections done under US make them a little less painful IMO.https://sportdoctorlondon.com/ultrasound-injections-doctor/
I had a cortisone injection in my right thumb without the guided ultrasound by a regular physician and to be honest my thumb is swollen and hurts worse than before. I can’t wait for it to go away how can I alleviate the pain in the mean time
Hi Tomas, It depends on when you had the injection. If you had it more than 6 weeks ago, you could have another injection. If less than 6 weeks, then I’d treat the thumb with anti-inflammatory treatments such as ibuprofen tablets/gel etc.
Can cortisone injections in the thumb joint due to arthritis cause weight gain?
No. The effect of one or two cortisone injections is unlikely to cause weight gain.
I understand that injections can only be done a limited number of times. Is this true?
Generally yes. We think that over time the effect lessens. Also, there is some evidence that repeated injections over a few years can hasten arthritis changes. see this blog – which discusses these issues in a little more detail.
https://sportdoctorlondon.com/how-long-does-it-take-for-a-cortisone-shot-to-work/
Lorenzo
Thanks for the information. I have had my first injection and trusted the Dr, hurt like you wouldn’t believe, however this was to be expected and explained. My had yes the next day a bit tender well there was a needle it the joint. Some panadol helped. Looking forward to some relief from arthritis pain.
Hi
I have just had a injection into the base of my thumb under ultra sound,, it was not cortisone but cannot remember the name..
After numbing the area I had syringe put to the needle which broke, they then put another syringe to the needle but found the thread and damaged,,
So the needle was withdraw and a new needle/syringe inserted ..
This was Wednesday and my hand is still very swollen and painful and tender..
Would this be normal I cannot use my hand
HI Steve, It is common to have a flare after an injection for up to 5 days with cortisone and even longer for other injections such as hyaluronic acid.
Lorenzo