“On the length, strength, free lateral motion and perfect
mobility of the thumb, depends the power of the human hand”
~Sir Charles Bell, 1833~
Tends to occur in women older than 40 years of age (Dray & Jablon, 1987; Jonsson & Valtysdottir, 1995) and affects 1/3 of females over the age of 50 (Armstrong, 1994).
A painful thumb can truly limit the ability to perform activities.
In fact, a severely painful thumb can limit hand function by 45% (Swanson, 1973).
1. Pain / aching around base of thumb – may radiate down thumb or up forearm
(usually most intense during pinch)
2. Tenderness over the CMC joint3. Stiffness in the CMC joint in the morning or
after inactivity
If inflammation is severe – 1. Swelling2. Warmth3. redness
Reduce excessive loading on joints
Avoid pain in activities
Distribute as much load over several joints
Use stronger, larger joints
Avoid twisting forces
Use joints in their most stable and functional positions
Maintain ROM
Balance activity and rest
Avoid staying in one position for long periods / static grips (Melvin, 2002)
Reduce effort
Nice Guideline 59 – Osteoarthritis People with osteoarthritis who have biomechanical joint
pain or instability should be considered for assessment for bracing/joint supports as an adjunct to their core treatment.
Valdes & Marrik (2010) The current literature supports the use of orthotics, hand
exercises, application of heat, and joint protection education combined with provision of adaptive equipment to improve grip strength and function.
Rannou et al (2009) Night time splinting is an effective treatment of base of
thumb OA
Day et al (2004) Thumb splinting together with corticosteroid provides
relief – unable to solely attribute effects to either modality
Carreira, Jones & Natour (2007) Splint is effective to decreased pain scores in
trapeziometacarpal OA patients
Boustedt & Nordenskold (2007) Women with thumb base OA can expect
improvement concerning pain on motion and hand grip force post hand OA programme partipation and combining it with night splints they can expect decreased pain at night.
Stamm et al (2002) Joint protection and hand home exercises, easily
administered and readily acceptable interventions, were found to increase grip strength and global hand function.
Splinting aims to enhance pain-free use of the thumb and allow individuals to partake in previously aggravating activities, without pain
“A splint by its very presence is doing harm as it inhibits free movement. It is only justified if the specific good compensates for the general harm”
Paul W. Brand
We all use our hands in different ways and so it is important to
look carefully at each individual, their
characteristics, needs and lifestyle.
Client Centred-ness Comfort Cosmesis Convenience Less is more Follow up
McKee & Rivard (2004). Orthoses as enablers of Occupation: Client centred splinting. Canadian Journal of Occupational Therapy (71, 306-314).
Hours: 8.30 – 16.30
Monday - Friday
Cost: Inpatient:
Outpatient:
Included in bed rate
€70/hr, €60/45mins€50/30mins, €30/15mins
Aids / Appliances: Supplied and billed
Referrals to be sent to:
Occupational Therapy Department, Bon Secours Hospital, College Road, Cork.021 4801630
Details to be included:
Name, Address, DOB, contact number, medical history and presenting complaint.