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 (CMC) joint. In many cases, people often ask about a cortisone injection in thumb joint. What is thumb arthritis, and when should you undergo a CMC joint injection? Does a steroid injection for thumb arthritis work?
What are the Symptoms of Thumb Arthritis?
Thumb arthritis usually causes pain, swelling, and stiffness at the base of the thumb. The 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. Other findings include restriction in thumb movement, decreased strength, and a bony appearance at the base of the thumb. Sometimes, using a computer mouse may reproduce thumb pain.
Factors that can increase the risk of thumb arthritis include being female sex, being over 50 years of age, having previous injuries such as cracks or sprains, jobs that place high stress on the thumb, and being obese.
How Do We Diagnose Thumb Arthritis?
Often, we diagnose thumb arthritis using a combination of clinical tests and X-rays.
Clinical findings typically include tenderness at the base of the thumb, restricted thumb joint movement, and reduced thumb strength.
An X-ray of the thumb shows a narrowed joint space, spur formation, and a deformed joint.
Overall, assessing every patient with thumb pain is essential to ensure there is no other cause, such as De Quervain’s tenosynovitis, trigger thumb, STT joint arthritis, 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 stretching and strengthening exercises for the thumb, wrist, and forearm. A hand therapist may use manual therapy techniques to improve thumb movement. For example, a thumb spica splint can help reduce pain by limiting thumb movement while still allowing thumb use.
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 your thumb when your pain is severe or when thumb arthritis prevents you from performing simple activities such as dressing, cooking, or cleaning.
Recent evidence suggests ultrasound-guided injections for thumb arthritis are more accurate and effective than blind injections. Specifically for CMC joint injections, ultrasound-guided injections are 94% accurate, compared with 80% for blind injections. In addition, cortisone injections for the thumb provide good pain relief for up to 6 months.
What about gel injections for thumb arthritis?
Some doctors think that gel injections, or hyaluronic acid injections, are also helpful for thumb arthritis, although we need more evidence to support this view. Gel injections, or hyaluronic acid injections, are used for arthritis. However, a recent paper suggests there are no favourites for the first CMC joint injection.
What about PRP injection for thumb arthritis?
A PRP injection has shown a good effect on knee arthritis, but no evidence exists that PRP helps thumb arthritis. Nevertheless, we would consider a PRP injection for thumb arthritis in people who have failed other treatments, including a cortisone injection.
If a CMC joint injection is inadequate for pain relief, we will consider a surgical procedure such as fusion, bone excision, or thumb joint replacement.
Final Word from Sportdoctorlondon about a Cortisone Injection in Thumb Joint
Thumb arthritis is a common condition characterised by pain during simple activities and restrictions in thumb movement. Simple treatments such as hand therapy and splints can help. An ultrasound-guided steroid injection for thumb arthritis 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.
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
I received cortisol injections over a year ago and I still have a horrible sensation in my thumb .like pins and needles all day long .even my clothes rubbing off my thumb is so irritating, I’m wondering is there another injection I can get to take away this sensation as it is driving me mad ..
Hi Frances – unusual reaction. I think you’ve had a nerve reaction to the injection.
I would avoid further injections.
You could try topical creams such as capsaicin – which help to reduce sensitivity.
I had a cortisone shot, it helped 50%. but now after months is remains black and blue all the time. Is there anything i can do so my hand doesn’t look sooo bad?
Hi Carol, I suspect you’ve developed skin discolouration from the cortisone injeciton: see this blog regarding side effects.
https://sportdoctorlondon.com/do-cortisone-shots-cause-weight-gain/
Although it looks cosmetically unappealing, I can reassure you that the effects will normalise slowly over next 6-12 months (perhaps longer if you have pigmentation).
I am 57 years old. I have been negative in both arthritis and osteoporosis . The main swelling is in my thumbs but within the last couple of weeks some of my fingers and toes are crossing over, which the consultant didn’t see.
I am booked in for bilateral injections into my thumbs , with no discussion with my consultant . I have cancel the appointment as I have had no discussion about this .
Please can you advise me on what I should do.
Kind regards
Michele Coe
Hi Michelle, I think you should discuss your concerns with your consultant. Nevertheless, a cortisone injeciton into the thumb joints for pain is a low risk.
LM
Both my Thumbs are shot, my right thumb had been slowly going bad but I don’t know if this aggravated but right after my 2nd Covid shot my left thumb went bad almost immediately and my right thumb got worse. Maybe a coincidence but questionable. But now I have 2 bad thumbs and I’m still painting houses. Most things I have to do involve holding a handle so it’s not as bad. I wish Everytime I have to sign my name I get angry that’s it’s painful to just hold a pen . I try my best to not use my thumbs and use my whole hand for things or even 2 hands but you kind of need your thumbs. I wish I could take my thumb joint out, send it down and put it back in, I’m kind of surprised there isn’t an operation for that I might as well add in at the same time that both my knees are troublesome as well. Very frustrating.
You could try a hyaluronic acid injection. Or surgery is an option.
LM
I have this arthritis in my left thumb for two years almost. I just went to see this female doctor and she said its inflammation, so I need a steroid injection in my thumb. I looked up for this injection, it’s no good. I am 67yo, I have never had a covid injection. I know it’s killing a lot of people around the world. I am still working as a bus driver. I am not going to this doctor again and I will not going to have an injection in my thumb. I massage my thumb with black seed oil, bcos it’s good to drink organic black seed oil for inflammation. Now I massage my thumb with it. I know every time I ate sweet stuff like yesterday I almost finished a packet of a cream biscuits now it’s very sore. Please stay away from sweet stuff. I am massaging my thumb with the black see oil and I take a tablespoon of it as well. It helps with our arthritis.