Not sure which treatment is right for you? This page puts every option for thumb base arthritis side by side, from a simple brace to joint replacement, so you can see them clearly before you talk to your doctor. It is based on published clinical evidence.
Non-surgical or surgery: the quick version
Treatment without surgery
Best for early arthritis (Eaton stage I to II). No operation and no anaesthetic. It can delay or even prevent surgery, and it works well together with injections. It may need to be kept up over time.
Surgery
Best for more advanced arthritis (Eaton stage III to IV). It is a lasting fix for severe pain, with several types of operation to choose from. Recovery takes six weeks to six months, and most people are satisfied (about 85 to 95 percent).
Every treatment, side by side
| Treatment | Type | Best stage | Pain relief | When it helps | How long it lasts |
|---|---|---|---|---|---|
| Thumb splint | Non-surgical | I to III | 30 to 50% less pain | Right away | Ongoing |
| Hand therapy | Non-surgical | I to III | Moderate | Right away | 8 to 12 week programme |
| Cortisone injection | Non-surgical | I to III | Strong (about 70%) | 1 to 2 days | 3 to 6 months |
| Hyaluronic acid injection | Non-surgical | I to III | Moderate | 1 to 2 days | 6 to 12 months |
| PRP injection | Non-surgical | I to III | Moderate to good | 2 to 3 days | 6 to 12 months |
| Fat injection | Non-surgical | II to III | Early data | 1 to 2 weeks | Still being studied |
| Trapeziectomy | Surgery | III to IV | 85 to 90% satisfied | 6 to 12 weeks | Permanent |
| Trapeziectomy with LRTI | Surgery | III to IV | 85 to 95% satisfied | 8 to 12 weeks | Permanent |
| Joint replacement (implant) | Surgery | III to IV | 90 to 95% satisfied | 4 to 8 weeks | 10 to 15+ years |
| Fusion (arthrodesis) | Surgery | III to IV | High (removes pain) | 8 to 12 weeks | Permanent |
| Arthroscopy | Surgery | I to II | Varies | 2 to 4 weeks | Varies |
| Osteotomy | Surgery | I to II | Good for some patients | 6 to 8 weeks | Long-term |
Stages I to IV are the Eaton-Littler grades, a way of describing how far the arthritis has progressed on an X-ray. Your surgeon will confirm your stage.
A simple way to think about the choice
This is a rough guide, not a rule. Your surgeon will look at your own X-rays, bone quality, age, and how you use your hand.
- Just diagnosed? Start with a brace and hand therapy.
- After 3 to 6 months, still not enough relief? Try an injection (cortisone or hyaluronic acid).
- Still in pain and at stage III or IV? Talk to a hand surgeon about an operation.
- Younger and active? A joint replacement often means a faster recovery.
- Older or lower demand on the hand? Trapeziectomy has a long, proven track record.
- Arthritis in several thumb joints (stage IV)? Trapeziectomy is usually preferred, as an implant may not suit.
Compare the implants
Every thumb implant with its survival and revision data.
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The full roadmap, step by step.
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This comparison is based on published clinical evidence and is for education only. Results vary from person to person. Always talk to a qualified hand surgeon or hand therapist about your own case.