Which Injection Works Better for Thumb Arthritis Pain?

If you have thumb pain that makes it hard to open jars, hold a pen, or button your shirt, you are not alone. Many people struggle with pain at the base of the thumb. This pain often comes from a condition called rhizarthrosis, also known as thumb arthritis.

Doctors sometimes offer injections to help ease the pain. But which type of injection works best? A recent study compared two popular treatments: hyaluronic acid injections and corticosteroid injections. Here are three important things the study found:

• Both types of injections helped reduce pain and improve hand function.
• Patients with more severe pain got even better results from hyaluronic acid over time.
• The benefits lasted for at least six months.

What Is Rhizarthrosis?

This condition is very common. It often makes it painful to pinch, grip, or twist things with your thumb. Even simple tasks like turning a key or opening a bottle can hurt.

You may be wondering why this matters.

Because thumb pain can make daily life much harder. Finding the right treatment can help you get back to the activities you love.

What Did the Study Look At?

According to this study published in Joint Bone Spine, researchers wanted to find out which injection worked better for thumb arthritis. They compared two treatments that doctors use often.

The first treatment was hyaluronic acid. This is a gel like substance that acts like a cushion inside the joint. Think of it as adding oil to a squeaky door hinge. It helps the joint move more smoothly.

The second treatment was betamethasone. This is a type of corticosteroid, which is a strong medicine that reduces swelling and pain. It works like putting ice on a swollen knee, but from the inside.

Both injections go directly into the thumb joint. Doctors use a special ultrasound machine to guide the needle to exactly the right spot.

How Did the Study Work?

The study included 88 patients who had thumb arthritis. All of them had moderate to advanced arthritis, which doctors measure using something called the Kellgren Lawrence grade. These patients had grade two or three arthritis, which means the problem was real but not the most severe.

Here is where it gets interesting.

The patients were split into two groups. One group got hyaluronic acid injections. The other group got betamethasone injections. Each patient received three injections, one week apart.

The doctors checked on the patients at different times: right after treatment, then at 7 days, 14 days, 30 days, 90 days, and finally at 180 days. That is six months of follow up.

The researchers measured two main things. They measured pain using something called a Visual Analogue Scale, or VAS. This is simply a way for patients to rate their pain from zero to ten. They also measured how well the hand worked using a Functional Index for Hand Osteoarthritis. This score tells doctors how hard it is to do everyday tasks.

What Were the Results?

Research shows that both treatments helped. In both groups, pain scores went down and hand function got better. This is good news. It means both types of injections can help people with thumb arthritis.

At first glance, the two treatments seemed about the same. The differences between the groups were not large enough to be certain they were real.

But let us look closer.

At 90 days, the hyaluronic acid group showed a trend toward better hand function. The difference was almost big enough to be sure it was real. The researchers found a p value of 0.071. When scientists talk about a p value, they mean the chance that the result happened by accident. A p value less than 0.05 usually means the result is real. So 0.071 is close, but not quite there.

Who Improved the Most?

This is the most important part of the study. The researchers looked more carefully at patients who had worse symptoms at the start. They focused on people whose functional score was 5 or higher and whose pain score was 3 or higher.

According to medical evidence, patients with more severe symptoms got much better results from hyaluronic acid. At 90 days, the difference was clear and real. The p value was 0.005. At 180 days, it was still clear with a p value of 0.020.

When the researchers looked only at patients with high pain scores of 5 or more at the start, the results were even stronger. These patients had significantly better hand function at 180 days with hyaluronic acid. The p value was 0.004. That is a very strong result.

Even more interesting, these patients started feeling better faster. After just two injections at 14 days, their hand function was already better. The p value was 0.028.

Their pain also improved more. At 180 days, the average pain score was significantly lower in the hyaluronic acid group compared to the betamethasone group. The p value was 0.02.

What Does This Mean in Simple Terms?

If your thumb pain is mild, both injections will probably help you about the same. But if your pain is worse or your hand does not work as well, hyaluronic acid may give you better results. The improvement lasts longer and helps you do more with your hands.

Were the Treatments Safe?

Studies indicate that both treatments were well tolerated. That means patients did not have serious problems or bad reactions. This is important because safety matters just as much as how well something works.

Common Questions

What This Means for You

If you are living with thumb pain, there is hope. Both hyaluronic acid and betamethasone injections can help reduce pain and improve how well your hand works. Both are safe options.

The research suggests that hyaluronic acid may be the better choice if your symptoms are more severe. It helps improve hand function over time and the benefits last.

Talk with your doctor about your symptoms. Share how much pain you feel and what tasks are hardest for you. Together, you can decide which treatment might work best.

Remember, every person is different. What works well for one person may work differently for another. But now you have information to help guide your conversation.

Important Disclaimer

This article is for educational purposes only. It is not medical advice. It does not replace the guidance of your doctor or healthcare provider. Always talk with a qualified medical professional before making decisions about your health or treatment. Your doctor knows your specific situation and can give you personalized advice.

Scientific Source

Study Citation:
Monfort, J., Rotes-Sala, D., Segales, N., Montanes, F. J., Orellana, C., Llorente-Onaindia, J., Mojal, S., Padro, I., & Benito, P. (2015). Comparative efficacy of intra-articular hyaluronic acid and corticoid injections in osteoarthritis of the first carpometacarpal joint: results of a 6-month single-masked randomized study. Joint Bone Spine.

Link to study:
https://doi.org/10.1016/j.jbspin.2014.08.008