Pathogenesis, Diagnosis, and Non-operative Management Strategies for Basal Joint Arthritis: A Comprehensive Literature Review

The Carpometacarpal (CMC) joint of the thumb is crucial for hand function and relies heavily on ligamentous stability. Osteoarthritis of the first CMC joint, also known as basilar thumb arthritis (BJA), is a common degenerative disease, particularly among the elderly and postmenopausal women. This paper aims to explore the effectiveness of nonoperative treatment modalities in managing BJA by offloading the basal joint. This is a comprehensive review of existing literature on nonoperative treatments for BJA, focusing on orthoses, activity modification, and ergonomic tools. The study involves a detailed analysis of clinical studies and reviews addressing the conservative management of BJA. Key treatment modalities, such as orthoses for joint stabilization, exercises for improving flexibility, and ergonomic tools for offloading the joint, are evaluated for their efficacy in pain relief and functional improvement. The findings of this review suggest modalities to offload the basal joint and improve daily function in patients with BJA. Orthoses provide joint stabilization and, while ergonomic modifications and exercises help offload the CMC joint, addressing the increased forces experienced by the joint. Despite the prevalence of BJA, there is a significant gap in research on conservative management, highlighting the need for further studies to optimize non-surgical treatment strategies.