Helping You Deal With Arthritis For Improved Comfort & Function
Is thumb pain making it hard to open jars, twist a rag, or hold your phone? You’re not alone. One of the most common causes of thumb pain in adults is carpometacarpal (CMC) joint arthritis, affecting a hidden joint at the base of the thumb. This small, but mighty, important joint plays a big role in everyday hand function. It is said that the thumb provides 40% of hand function, so if arthritis is present, this can be a real hinderance on your ability to perform routine tasks.
While thumb CMC arthritis can’t be reversed, occupational hand therapy (OT, CHT) can help you to significantly reduce pain, preserve function, and learn strategies for joint protection. Here’s how.
What Is Thumb CMC Arthritis?
The CMC joint allows your thumb to move in multiple directions — gripping, pinching, and opposing to the other fingers. Over time, repetitive stress or degeneration of cartilage can lead to arthritis in this joint. If you have had an x-ray, you may have read interpretations such as: “joint space narrowing,” “osteophytes” or “degenerative joint disease”. These terms sound awful and perhaps scary, right? Unfortunately, these joint changes are a normal part of “wear and tear” on the body as we age. The medical term is “osteoarthritis” and the thumb is a common location for many of us.
Common symptoms include:
- Aching or sharp pain at the base of the thumb
- Weak grip or pinch strength
- Swelling or tenderness
- Difficulty with fine motor tasks like writing, turning keys, or fastening jewelry
OT Interventions for Thumb CMC Arthritis
Occupational therapists don’t only treat your symptoms. We aim to help you function better in your daily life. For CMC arthritis, this means reducing joint strain, supporting weakened structures, and improving movement patterns.
Activity Modification & Adaptive Techniques
One of the first lines of defense is changing how you use your hand during daily tasks to minimize stress on the joint. Your OT may recommend:
- Using larger, built-up handles on utensils, pens, keys, or grooming tools to reduce pinch force
- Two-handed techniques (e.g., using the non-dominant hand to stabilize objects)
- Jar openers and button hooks to assist with household and dressing tasks
- Lightweight kitchen and grooming tools to reduce lifting strain
- Ergonomic strategies for phone use, typing, or crafting
By learning joint protection principles, you can avoid the repetitive stress that leads to pain and progression.
Orthotics for Joint Protection
A thumb CMC orthosis (or also called a splint) can provide critical support, especially during painful flare-ups or when you perform a repetitive activity or task that you have identified to trigger your symptoms.
Prefabricated or custom orthoses function to support or immobilize the thumb CMC joint, but it is important to have a support that allows motion at the thumb tip. Overly immobilizing the thumb can cause stiffness, so your OT will work with you to ensure that you have the right fit.
You may need different orthoses for different daily activities. Some tasks are better performed with a flexible neoprene support while other tasks call for a molded, rigid support.
Worn during functional activities or at night, splints help reduce inflammation and maintain joint alignment. Your OT will evaluate your joint alignment and activity demands to determine the best orthotic style and wearing schedule for you.
Therapeutic Exercises for Dynamic Thumb Stabilization
Targeted exercises can strengthen the small muscles around the thumb and improve joint control. The goal is not to “grit your teeth and bear it,” but to support the joint with better muscle balance. I always say that the mantra is not: “No pain, no gain,” but instead, “No pain, no pain.”
Your OT will show you strategies to do your exercises with proper support to your thumb to build the muscles while taking care not to irritate your joint. Common exercises include:
- “The o.k. sign” Press your thumb to each fingertip gently without joint collapse.
- Table top lift: Lift your thumb away from the palm while keeping the other fingers flat.
- Web space self-massage: Gently “strum” the muscles between your thumb and index finger to improve mobility.
Functional strengthening: train for stability without overload. I often say: “you go for precision, not power.”
Your OT will ensure these exercises match your pain level and support, not stress , your joint.
Real-Life Results: Why OT Matters
Clients with thumb CMC arthritis often come to therapy when daily activities become frustrating or painful. After a few sessions of personalized intervention (often including splinting, soft tissue mobilization, education and home exercises) many experience:
- Reduced pain during key tasks
- Improved grip and pinch strength
- Less fatigue in the hand and wrist
- Greater independence and confidence
I have often heard people tell me: “It hurts when I do ___, but I still do it because I don’t want to lose the ability to do it.”
We need to change the above mindset through joint protection education. It’s important to understand that when persisting with a task that causes pain, we stress the joint. This leads to a greater likelihood of no longer being able to perform the task as pain, joint instability and/or weakness occur. Activity modification and joint protection strategies aim to PRESERVE function over time. Changing the way we perform a task that causes pain allows the joint to settle down to prepare for muscular strengthening necessary for joint support. We can’t eliminate the arthritis, but we can strengthen the muscles around that joint.
When to Seek Help
If you’ve been experiencing thumb pain that interferes with your day-to-day tasks, don’t wait for it to get worse. An experienced OT Hand Therapist (CHT) can provide the education, tools, and support you need to manage your symptoms and preserve hand function for years to come.
Support your thumb and take control of your daily comfort.
Looking for Occupational Therapy, Certified Hand Therapy services in Evanston, IL? Click the link for my website and make an inquiry. Providing compassionate hand therapy care for clients in the Chicago area and North Shore.
If you need hand therapy and don’t live near Evanston, IL, click on the link for the HTCC website to search for a CHT near you.
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