I regularly review newly published, high-quality medical research and share patient-focused summaries explaining what the evidence means in everyday practice. These updates are intended to support informed discussions and shared decision-making, while recognising that treatment should always be tailored to the individual.
At the heart of my practice is Shared Decision-Making. Whether we pursue conservative management (Plan A) or surgical intervention (Plan B), the goal is to create a tailored treatment plan that aligns with your lifestyle, values, and functional goals.
Prepared by:
Prof. Bijay Singh
Consultant Orthopaedic Surgeon – Upper Limb, Trauma & Sports Injury
Shoulder | Elbow | Wrist | Hand
Visiting Professor Canterbury Christchurch University & AIIMS Raipur
NHS Appointments:
Spire Alexandra Hospital: 01634 – 687166
Medway NHS Trust: 01634 – 976749
KIMS Hospital
Spire Alexandra Hospital
Lyca Health Orpington
Medway NHS Trust
What is thumb base arthritis?
Thumb base arthritis occurs when the cartilage at the base of the thumb wears down. This can cause pain, weakness, and difficulty with everyday tasks.
Nonoperative treatment options
- Activity modification
- Hand therapy and strengthening exercises
- Supportive thumb splint (orthosis)
- Pain relief medication if required
- Steroid injections in selected cases
What did the study look at?
- Multicentre prospective study
- Over 200 patients with thumb base arthritis
- Treated with exercise therapy and splinting
- Median follow-up: 6.6 years
- Measured pain, function, satisfaction, and surgery rates
Key findings
- Pain scores did not worsen after the first year
- Function in daily activities remained stable
- Over half of patients were satisfied with treatment
- Only 22% required surgery within about 7 years
- Nearly 4 out of 5 patients avoided surgery
Professor Singh’s commentary
Nonoperative treatment can provide good outcomes for many years. Steroid injections may provide prolonged pain relief in selected patients. Treatment should always be based on shared decision-making.
Reference
Lopez G et al. Long-Term Outcomes of Nonsurgical Treatment of Thumb Carpometacarpal Osteoarthritis. JBJS, 2023.
