If you have pain at the base of your thumb, you may hear the word rhizarthrosis. It can make small tasks like opening a jar or turning a key feel hard. You are not alone.
A new study from 2024 shows a fresh method that mixes manual therapy with specific exercises for thumb arthritis. The goal is to make how your thumb joint works better and to ease pain. This is not a normal general hand exercise plan. It targets how your thumb joint moves and what goes wrong in arthritis.
Here are three main points from the study:
- A three phase manual therapy method that focuses on your thumb joint in a step by step way.
- A specific exercise using a simple rubber band to strengthen a muscle that helps stabilize your thumb.
- A treatment plan built on understanding how your thumb joint actually moves and what goes wrong in arthritis.
Key Findings at a Glance
- This treatment approach is designed for people with mild to moderate thumb arthritis (Eaton-Littler grades I and II).
- The manual therapy includes three phases: passive joint distraction, active movement with therapist help, and mobilization with movement.
- The exercise focuses on strengthening the first dorsal interosseous muscle, a small muscle between your thumb and index finger that helps stabilize your thumb.
- Patients are encouraged to use a rubber band between the first and fifth fingers to perform finger spreading exercises without moving the painful thumb joint itself.
- The protocol needs further testing in clinical trials to confirm its effectiveness.
We simplify medical science for people living with thumb pain and rhizarthrosis. Every article on this site is based only on published scientific research. We translate complex studies into plain language so you can make informed decisions about your care. Explore more content to learn what the latest science says about managing your thumb arthritis.
What is rhizarthrosis and why does it hurt?
Rhizarthrosis is the medical name for arthritis at the base of your thumb. The joint where your thumb meets your wrist is called the trapeziometacarpal joint. When the cartilage in this joint wears down, bones rub together. This causes pain, swelling, and stiffness.
You may wonder why this matters. Your thumb helps with almost every hand movement. When it hurts to use your thumb, your whole hand becomes less useful. Simple actions like holding a cup or buttoning a shirt become challenges.
According to this study, conservative treatment is preferred for mild to moderate cases. Conservative treatment means approaches that do not involve surgery. This includes manual therapy, exercises, and other hands on methods.
What is the problem with current treatments?
Research shows that existing manual therapy techniques lack comparative studies. This means doctors and therapists do not have strong evidence showing which techniques work best. The exercises often given to patients are generic. They are not designed specifically for the unique way the thumb joint moves and fails in arthritis.
Here is where it gets interesting. The authors of this study looked closely at the biomechanics of the thumb joint. Biomechanics means studying how the bones, muscles, and joints move and work together. They used this knowledge to create a treatment plan that targets the exact problems in thumb arthritis.
What does this new approach involve?
The proposed treatment has two main parts:
- Manual therapy performed by a trained therapist.
- Specific therapeutic exercises you can do at home.
The goal is to enhance joint stability, reduce pain, and improve function. Stability means the joint stays in the right position during movement. When a joint is unstable, it can move in ways that cause more damage and pain.
This approach is based on biomechanical analysis. The researchers did not guess what might help. They studied how the joint works and what goes wrong in arthritis. Then they designed treatments to address those exact issues.
How does the manual therapy work?
The manual therapy part has three phases. Each phase builds on the one before. Here is what happens in each phase.
Phase One: Passive Joint Distraction
During this phase, the therapist gently pulls the joint surfaces apart. This is called distraction. It creates space in the joint and can reduce pressure. The goal is to ease discomfort and improve joint movement. Mobility means how easily the joint can move.
You do not do anything in this phase. You relax while the therapist does the work. This is why it is called passive.
Phase Two: Active Movement on the Adduction and Abduction Plane
This phase covers movement on a specific plane. The adduction and abduction plane refers to moving your thumb toward your hand and away from it. Adduction means bringing your thumb close to your palm. Abduction means moving it away.
According to the study, this is the first plane of movement to suffer limitation in thumb arthritis. That means this movement becomes stiff and painful early in the disease.
The therapist helps you perform isometric adduction of the thumb. Isometric means you activate the muscle without actually moving the joint. You push against resistance but nothing moves. After that, the therapist assists you with abduction. You actively move your thumb away from your hand while the therapist provides gentle help.
Phase Three: Mobilization With Movement
This phase uses Mulligan’s Mobilization With Movement. This technique involves passive pain free joint mobilization at the same time you actively move your fingers. Passive mobilization means the therapist moves your joint gently. Active movement means you are also doing a movement yourself at the same time.
The combination of these two actions is thought to provide additional therapeutic benefits. The therapist moves the joint in a way that should not cause pain while you perform a functional movement. This retrains the joint to move correctly.
What exercises should you do?
The therapeutic exercises focus on strengthening a specific muscle. This muscle is called the first dorsal interosseous. It sits between your thumb and index finger. It acts as an abductor, meaning it helps pull your thumb away from your hand.
You may be wondering why this muscle matters. When this muscle is strong, it reduces activation of the thumb adductor muscles. The adductor muscles pull your thumb toward your hand. When they are overactive, they create stress on the joint. By strengthening the abductor, you balance the forces acting on your thumb.
How to perform the exercise
Patients are encouraged to perform finger spreading exercises using a rubber band. Here is how it works:
- Place a rubber band around your hand so it goes between your first finger (thumb) and your fifth finger (pinky).
- Spread your fingers apart against the resistance of the rubber band.
- Focus on activating the first dorsal interosseous muscle and keeping your thumb stable.
This type of muscle strengthening does not involve movement of the trapeziometacarpal joint itself. You are working the muscle without moving the painful joint. This is a key feature of the exercise.
How often and how much?
The study recommends starting gently. Begin with 5 to 10 repetitions or hold an isometric contraction for 5 seconds. Repeat this throughout the day. As you get stronger, you can increase the load. You can do this by adding a turn to the rubber band to make it tighter or by using a thicker rubber band.
| Starting Point | How to Progress |
|---|---|
| 5 to 10 repetitions | Increase to 15 repetitions |
| 5 seconds isometric hold | Increase to 10 or 15 seconds |
| Light rubber band | Add a turn or use a thicker band |
Frequently Asked Questions
Is this treatment proven to work?
The authors state that empirical validation through rigorous clinical trials remains essential. This means the treatment has a strong theoretical foundation based on biomechanics, but it still needs to be tested in real patients in controlled studies. The proposed approach is promising but not yet proven.
Who is this treatment for?
This treatment protocol is for people with mild to moderate thumb arthritis. The study mentions Eaton-Littler grades I and II. These describe how advanced the arthritis is. Grades I and II are early to moderate stages. If your arthritis is more severe, this approach may not be right for you.
Can I do the exercises at home?
Yes, the finger spreading exercises using a rubber band are designed to be done at home. You are encouraged to repeat them throughout the day. However, the manual therapy phases should be done by a trained therapist. Always talk to your healthcare provider before starting any new exercise program.
Why does this approach focus on one muscle?
The first dorsal interosseous muscle plays a key role in stabilizing the thumb and balancing the forces around the joint. The study says strengthening this muscle as an abductor reduces the activation of thumb adductor muscles. This lowers joint stress and may reduce pain and further damage.
What does this mean for you?
If you live with thumb arthritis, this study offers hope. It presents a new way of thinking about treatment. Instead of generic exercises, this approach is built on understanding exactly how your thumb joint works and what goes wrong in arthritis.
The combination of manual therapy and targeted exercises aims to improve joint stability, reduce pain, and restore function. The exercises are simple and can be done at home with just a rubber band. The manual therapy needs a trained professional but is divided into clear phases that address specific problems.
The next step is for researchers to test this protocol in clinical trials. If those trials show positive results, this could become a standard treatment option for people with early thumb arthritis. In the meantime, talk to your doctor or hand therapist about whether this approach might be right for you.
Important Disclaimer
This article is for information only. It is not medical advice. Always talk to your healthcare provider before starting any new treatment or exercise program. Your doctor can assess your condition and recommend the best approach for you.
Research Source
This article is based on the study by Colonna, S. and Borghi, C., published in Cureus in 2024.
Read the full study here: https://doi.org/10.7759/cureus.52999