Thumb arthritis: are steroid injections worth it?

Thumb arthritis occurs in the joint at the base of the thumb, which is known as the carpometacarpal joint. Osteoarthritis (the loss of cartilage) is a common condition in this joint, which is the result of wear and tear. Pain usually presents with pinching and gripping activities and in severe cases, a patient can experience pain at rest or at night.

We asked one of our expert orthopaedic surgeons, Mr Andrew Logan, what the treatment options are for arthritis of the thumb and whether steroid injections are useful in managing pain.
 

What are the treatment options for thumb arthritis?

When it comes to treating arthritis of the thumb, there are a few options:

Do nothing
If the symptoms are mild then nothing needs to be done. The patient may need to modify the way that they use their hand to prevent pain in scenarios such as using kitchens aids to help remove jar or bottle tops or to open tins. Simple pain killers can provide relief.

Splinting
Splints can be worn during activities that are painful to restrict some of the movement in the base of the thumb. Splints can either be “off the shelf” or specially moulded out of plastic by hand therapists. Some people find hand splints helpful, whilst others do not get on with them. 

Steroid injections
Steroid injections can be used to temporarily improve the pain experienced in cases of thumb arthritis.

Surgery
There are a few different operations for osteoarthritis at the base of the thumb but no surgical procedure can restore the cartilage that has been lost or restore the thumb to normal. The type of operation depends on the individual case and the hand specialist will take the age of the patient and the demand on the hand into consideration.

Operations include stiffening the joint, replacing it, putting a spacer in the joint or completely removing it. Although the majority of patients will benefit from surgery not all patients get a good short-term or long-term result. An operation should only be considered when another treatment option has not been successful in helping.
 

How do steroid injections work?

It is not known how a steroid injection works exactly, however, it is most likely that the steroid injection helps to calm down the inflammation around the joint.
 

Can steroid injections cure thumb arthritis?

Steroid injections do not improve the underlying condition, which is the worn cartilage in the joint but calm down the symptoms of inflammation. Therefore as the osteoarthritis is still there, it means that the inflammation is likely to return as the steroid injection has “worn off”.
 

How long does it last

Every patient has a different response. It is expected that half of patients will have pain relief for less than three months. One in six patients are still benefiting from the injection at six months.
 

How often can I have a steroid injection?

Each subsequent injection tends to last less time. A minimum time period of four months between injections is reasonable. If the injections are required that frequently, however, it may be worth considering surgery.
 

Is it worth having steroid injections for thumb arthritis?

In the majority of cases, it is worth it. If you are fortunate enough that the injection lasts a long time then it can delay the need for an operation.


Mr Logan specialises in hand and wrist surgery, including conditions such as carpal tunnel syndrome, Dupuytren’s contracture, trigger finger and hand arthritis. You can book an appointment with him via his Top Doctor’s profile here.