Thumb arthritis is a common condition that affects many people as they get older, especially if they’ve spent years using their hands in repetitive ways for work. When your thumb hurts, simple tasks like turning a doorknob or picking up a cup can become difficult, adding new limitations and restrictions to your life.
If you’re dealing with this pain, you might be eager to learn about the treatment options available—and that’s exactly what this article is about. While the idea of finding the “best” surgery highly depends on your personal health situation, we’ll explore some of the traditional options here as well as “denervation”, a new favourite, to explain how it may help you find relief.
The Nerve Surgery Centre, founded by Mr. Tomas Madura, provides surgical solutions to arthritis and carpal tunnel surgery in Birmingham. We know that when it comes to hand and nerve care, getting trusted advice is essential. What happens if you use your hand too soon after carpal tunnel surgery or arthritis surgery? What are the recovery timelines like? If you have questions about a procedure, we can provide the answers with no judgement or expectations.
Why Understanding Thumb Arthritis Matters
Thumb arthritis can sneak up on you. In the beginning, you might notice small twinges of pain when twisting open jars or writing a note. Over time, that pain can become more frequent and more intense, making day-to-day tasks a real challenge.
Advancements in surgical techniques offer fresh hope for those who want to keep as much mobility as possible without the prolonged recovery times that often come with other procedures.
What Is Thumb Arthritis?
Thumb arthritis is a form of osteoarthritis (also called “wear and tear arthritis”) that affects the joint at the base of your thumb—known as the carpometacarpal (CMC) joint. When the protective cartilage around that joint breaks down, it can lead to inflammation, pain, and stiffness.
In simpler terms, thumb arthritis happens when the cushioning between your thumb bones starts to wear away. This makes the bones rub together more often, which causes pain and swelling. Over time, this can affect how you move your thumb and grip objects.
Common Symptoms and How They Impact You
- Pain at the base of your thumb – This can happen when you pinch, grasp, or twist something.
- Swelling – The area might look slightly bigger or feel tender.
- Stiffness or reduced range of motion – You might struggle to move your thumb fully or experience stiffness, especially in the morning.
- Weak grip – Tasks like opening jars, turning keys, or holding onto small items become more challenging.
These symptoms can interfere with your ability to do simple activities like using a mobile phone or carrying a shopping bag. Over time, the pain can become a daily reminder of how important the thumb is for almost every hand movement.
Causes and Risk Factors
Thumb arthritis is most commonly caused by osteoarthritis, which is age-related wear and tear of the joint. However, there are other factors that can increase your risk. Jobs or hobbies that involve frequent thumb use can speed up cartilage breakdown, and previous thumb injuries can potentially set you up for problems later on in life.
There is also a genetic component to it, as some people are more likely to develop arthritis if it runs in the family. Arthritis becomes more common as you grow older, especially past middle age.
What Is Denervation for Thumb Arthritis?
Surgery is sometimes necessary for managing severe thumb arthritis, especially when non-surgical treatments like splints, medications, or injections haven’t helped enough. Denervation for thumb arthritis is an approach that focuses on the nerves around your thumb joint. By targeting the specific nerves that send pain signals, surgeons can help you find relief without permanently altering your joint structure.
A Simple Explanation of Denervation
During denervation, your surgeon carefully identifies and interrupts the small sensory nerves in your thumb area. These nerves are responsible for sending pain messages to your brain. By “turning off” these signals, you can experience relief even though the structure of your thumb joint remains the same.
Denervation doesn’t remove your arthritic joint. Instead, it addresses the main problem: the constant pain. You can think of it as muting the volume on a loudspeaker that’s been blasting discomfort signals to your body.
Why Denervation Could Be the Best Surgery For You
Denervation has gained attention in recent years due to advancements in microsurgery and nerve-specific techniques. Compared to established procedures like fusion or replacement, it directly targets the pain pathway rather than the bone or cartilage. Specialists and researchers have been experimenting with ways to refine nerve-related surgeries, and denervation is one of the outcomes of these studies.
Not every hospital or clinic offers denervation just yet, as it often requires specialized training. Still, as more surgeons gain experience and more research supports its benefits, denervation is expected to become more widely available.
How Does Thumb Denervation Work?
If you’re wondering how denervation compares to a more traditional surgical approach, understanding the steps involved can help ease your worries and show why this method might be worth considering.
Steps of a Denervation Procedure
Step 1: Pre-Surgery Assessment
Your surgeon will look at your thumb, possibly take X-rays, and discuss your medical history.
Step 2: Marking the Nerves
Using their knowledge of the nerve pathways, the surgeon identifies the sensory nerves around the base of your thumb.
Step 3: Nerve Interruption
Small cuts or clips are used to disable these pain-transmitting nerves. This is often done through small incisions around the thumb joint.
Step 4: Closing and Dressing
The incisions are stitched or sealed, and your hand is bandaged to keep the area clean and supported.
How Long Does the Operation Take?
The operation itself usually takes around 45 to 60 minutes, depending on how much work needs to be done and whether there are other hand issues to address. Majority of patients have the procedure as a day case, meaning they go home the same day if all goes well. However, the exact timeline can vary based on your overall health and the specifics of your surgery.
What Is the Recovery Process Like?
Right after surgery, you might have a bandage or splint around your thumb to protect the incisions and allow your nerves to settle. Most people need to rest their hands for a few weeks. Here’s what a typical recovery might look like:
- First few days – Keep your hand elevated, follow any pain management plan, and watch for signs of infection.
- 1–2 weeks post-surgery – Stitches or bandages may be removed, and gentle movements can begin if your surgeon approves.
- 2–3 weeks post-surgery – Gradually return to activities, depending on how your thumb feels. Physical therapy or hand exercises might be recommended.
- 3–6 weeks – Many people are back to most daily tasks, though complete healing can vary from person to person.
With denervation, the key is to let the nerves around your thumb heal while avoiding strain on the incisions. You’ll still feel your thumb, but the painful signals should be much quieter.
Will I still feel my thumb after denervation surgery?
Yes, the surgery only targets small nerves which bring the feeling of pain from the joint. The sensation on the skin of the thumb wll be unchanged after the procedure.
Traditional Surgery Options for Thumb Arthritis
Now that we’ve explored a promising surgical technique—denervation—let’s look at some of the more traditional options. As mentioned previously, the best treatment for thumb arthritis does depend on your personal medical situation. Consult with a medical professional for an expert opinion on what would work better for you.
Joint Fusion (Arthrodesis)
In a joint fusion, the surfaces of your thumb bones are fused together so they can’t move against each other anymore.
| Pros | Cons |
|
|
Trapeziectomy
Trapeziectomy is an operation where one of the bones forming the painful, arthritic joint under the thumb is removed. This results in elimination in one of the painful joint surfaces and produces pain relief.
| Pros | Cons |
|
|
Joint Replacement (Arthroplasty)
In this procedure, the surgeon removes the damaged parts of the joint and replaces them with an artificial implant. This can restore some mobility and relieve pain.
| Pros | Cons |
|
|
What Are the Benefits of Denervation Over Other Surgeries?
Denervation is growing in popularity because it aims to keep the structure of your thumb intact while shutting down those life-limiting pain signals. Here are some advantages it may offer over other procedures.
Pain Relief Without Losing Range of Motion
Unlike a joint fusion, which locks your thumb in place, denervation doesn’t restrict movement. You can continue to bend and twist your thumb as usual, which is a big plus for people who value fine motor skills and everyday hand functions.
Potential for Faster Recovery
Because denervation doesn’t involve installing an implant or making major changes to the joint itself, recovery can be quicker for some people. While any surgery has a healing period, denervation patients often find that they return to light activities and daily tasks sooner than those who undergo joint fusion or replacement.
Preservation of grip strength
The denervation procedure does not affect the way the thumb joints move and if the patient had a stable grip before the operation but wasn’t able to use it because of pain, this will be preserved after surgery. After removing the pain the thumb will feel as stable and strong as before the problems started
Fewer Mechanical Complications
With traditional surgeries, there’s always a risk that an implant could wear out or fail. With denervation, there’s no artificial joint to replace, and no bone is being fused. This means there might be fewer mechanical complications over time. You’re essentially keeping your own natural joint—just without the intense pain signals.
Is Denervation Safe?
Every surgery, no matter how routine, comes with some element of risk. That said, denervation is generally considered safe when performed by an experienced hand and nerve surgeon.
Understanding Potential Risks
- Infection – As with any surgical procedure, there’s a small risk of infection at the incision sites.
- Nerve irritation – Although the goal is to reduce pain, in rare cases, nerves can become irritated or develop neuromas (nerve swellings) that cause discomfort.
- Incomplete pain relief – Denervation targets specific nerves. There’s a chance some nerves might still carry pain signals, or new pain pathways might develop over time.
Most people who have denervation do very well, but it’s important to talk openly with your surgeon about these risks so you can make the best decision.
How Often Do Complications Occur?
Complications are uncommon, but like any procedure, they can happen. While specific statistics can be hard to track due to individual differences, most surgeons agree that serious issues are rare. Choosing a specialist with plenty of experience in nerve surgery is one of the best ways to reduce these risks.
Who Is a Good Candidate for Denervation?
Not everyone is a perfect fit for denervation. Your doctor will consider a range of factors, such as:
- The severity of your arthritis.
- Whether you have other hand or wrist issues.
- Your overall health and lifestyle needs.
If you still have decent joint movement but are held back by significant pain, denervation might be an option worth exploring. Patients with extreme joint damage, however, may be better served by a more traditional approach, like joint replacement.
Frequently Asked Questions
As denervation becomes more well-known, people have questions about what it feels like and how it compares to other surgeries. Here are some common concerns about thumb denervation.
Will I Still Feel My Thumb After Denervation?
Yes. Denervation targets the smaller nerves responsible for pain, not the main nerves that handle touch or movement. Most people still have general sensation in their thumb afterwards. You should talk to your surgeon about what sensations you can expect to retain.
How Long Does the Pain Relief Last?
Studies suggest that denervation can provide relief for several years. However, arthritis is a progressive disease, and nerve pathways can sometimes regrow. Some people might need another procedure in the future, but others continue to feel relief long term.
Can Denervation Be Reversed?
Once specific nerves are cut or interrupted, they can sometimes regenerate, but regrowth is not guaranteed. In many cases, the nerves do not fully reconnect. This can be both good (longer pain relief) and potentially challenging if you were hoping to restore the original nerve function.
Is Denervation an Option If I’ve Already Had Other Surgeries?
Yes, in many cases it is. You’ll need a thorough evaluation to see if it’s the right approach. Every surgical plan is personal, so it’s important to consult with a specialist.
What If Denervation Isn’t Right for Me?
If denervation isn’t the best choice, don’t worry—there are still other paths. Some people do well with continued physical therapy, steroid injections, or more established surgeries like fusion or replacement. It all depends on your individual situation. Your surgeon will help guide you toward treatments that suit your needs.
Conclusion
If you’ve been struggling with thumb arthritis pain and are looking for a solution that can preserve mobility while reducing discomfort, denervation might be worth exploring. At the Nerve Surgery Centre, our team specializes in treating peripheral nerve problems and offers a range of innovative surgeries tailored to your unique needs. From initial consultation to post-surgery follow-ups, we focus on giving you the highest quality care to help you regain the use of your hand—and your life.
We encourage you to book an appointment and reach out to our specialists to discuss whether denervation or another type of procedure might be right for you. With expert guidance and a focus on personalised care, you don’t have to live with constant thumb pain any longer.
Thank you for reading, and remember that help is available. If you’d like to discuss your options, get in touch with the Nerve Surgery Centre today.
Medically Reviewed by Mr Tomas Madura:
Mr Tomas Madura MD(Hons), PhD, FRCS(Plast), is a highly experienced Consultant Plastic Surgeon specialising in hand and peripheral nerve surgery, with over two decades in the medical field. He has been a Consultant at the Birmingham Hand Centre and Brachial Plexus and Peripheral Nerve Injury Service at the Queen Elizabeth Hospital in Birmingham since 2017. Mr Madura’s distinguished career includes a PhD in Neurobiology from Osaka University, multiple fellowships in reconstructive microsurgery and peripheral nerve surgery, and numerous contributions to research in the field of nerve injuries and paralysis.
He is a Fellow of the Royal College of Surgeons of Edinburgh and a full member of several prestigious organisations, including the British Association of Plastic Reconstructive and Aesthetic Surgeons and the British Society for Surgery of the Hand. Mr Madura has been recognised with the Syme Medal for outstanding contributions to surgical research.
For more information, please visit his About page.
DISCLAIMER: The information provided in this article is intended for general informational purposes only and should not be construed as medical advice, diagnosis, or treatment. The products and methods mentioned are not a substitute for professional medical advice from a trained healthcare specialist. Always seek the guidance of your doctor or other qualified health professional with any questions you may have regarding your health or a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. Use of the information and products discussed is at your own risk.