Thumb Base (CMC) Arthritis
Quick summary
Painful pinch and grip from thumb-base arthritis. Precise ultrasound-guided CMC injections in Oxford — accurate, well-tolerated.
Arthritis of the first carpometacarpal (CMC) joint is common in women over 50 and produces disabling pain with pinching, writing and opening jars. Blind injection frequently misses this small joint — ultrasound guidance is essential.
Key takeaways
- Painful pinch and grip from thumb-base arthritis. Precise ultrasound-guided CMC injections in Oxford — accurate, well-tolerated.
- Diagnosed with in-clinic ultrasound alongside clinical examination.
- Treated with a stepped, evidence-based plan — not one-size-fits-all injections.
- Self-referral available — no GP letter required.
Symptoms
- Pain at the base of the thumb with pinch grip
- Weakness opening jars, turning keys, using pens
- Visible squaring at the thumb base in advanced cases
Causes & risk factors
- Age-related cartilage loss
- Post-traumatic OA
- Female sex and family history
Who is most at risk
- Women over 50
- Family history
- Previous thumb-base injury
- Occupational or hobby-based repetitive pinch loading
Differential diagnosis
Conditions that can mimic Thumb Base.
- De Quervain's tenosynovitis
- Scaphoid fracture (post-trauma)
- Trigger thumb
- Wrist osteoarthritis
How we diagnose Thumb Base
X-ray grades severity (Eaton-Littler). Ultrasound identifies effusion, dorsal osteophytes and guides accurate joint access.
Treatment options
Ultrasound-guided CMC steroid injection
Well tolerated and generally effective for 3–6 months. Accuracy under ultrasound is far higher than blind injection.
Hyaluronic acid injection
For patients wishing to avoid steroid or with early disease.
Splint and hand therapy
Neoprene CMC splint plus thenar strengthening reduces load and pain.
Surgery
Trapeziectomy for end-stage disease — we refer selectively.
What we look for on ultrasound
Joint capsule distension, osteophytes at the trapezium and metacarpal base, cortical irregularity.
When to seek help
Book if thumb pain is limiting handwriting, gripping or independence — early injection can defer surgery for years.
Recovery timeline
Typical timeframes after diagnosis and treatment. Individual recovery varies — your clinician will personalise this plan.
- 1Week 0–2Post-injection
Rapid pain relief after steroid or hyaluronic acid injection.
- 2Week 2–8Splint & retrain
Custom thumb splint for aggravating tasks; pinch strengthening.
- 3Month 3–12Maintenance
Repeat injection when needed; discuss surgical options in advanced disease.
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Related conditions we treat
Explore other musculoskeletal conditions assessed and treated at the clinic.
- Frozen Shoulder (Adhesive Capsulitis)
- Rotator Cuff Injury
- Calcific Tendinitis of the Shoulder
- Hip Osteoarthritis
- Greater Trochanteric Pain Syndrome
- Knee Osteoarthritis
- Tennis Elbow (Lateral Epicondylalgia)
- Golfer's Elbow (Medial Epicondylalgia)
- Trigger Finger
- Carpal Tunnel Syndrome
- Plantar Fasciitis
- Achilles Tendinopathy
Related symptom guides
Patient-friendly guides that describe how elbow & wrist problems typically present.
- Pins and Needles in the Hand — Common CausesNumbness or tingling in the hand — especially at night — is most often carpal tunnel syndrome. Learn how to distinguish nerve entrapment causes.
- Elbow Pain When Gripping — Tennis & Golfer's ElbowElbow pain when gripping, lifting or shaking hands usually means tennis or golfer's elbow. Learn how they differ and the best treatments.
- Wrist Pain When Typing — Causes & What HelpsWrist and hand pain from keyboard or mouse use is often carpal tunnel, de Quervain's tenosynovitis or intersection syndrome. Learn how each is diagnosed and treated.
- Pain at the Base of the Thumb — Diagnosis & TreatmentPain at the base of the thumb when pinching, opening jars or lifting is often thumb CMC arthritis or de Quervain's tenosynovitis. Learn how each is diagnosed and treated.
Related treatments
Ultrasound-guided procedures we use to treat musculoskeletal conditions.
Thumb Base assessment & treatment across Oxfordshire
We treat thumb base patients from across Oxfordshire and the surrounding counties. Two hours of free parking is available directly at the clinic in Botley, OX2.
How we make treatment decisions
Every recommendation at Oxford Injection Clinic is shaped by current UK guidance — including NICE recommendations for musculoskeletal pain, published NHS guidance on injection therapy, and peer-reviewed evidence from British and international MSK medicine journals. We follow a stepped-care model: accurate diagnosis first (clinical examination and diagnostic ultrasound), conservative measures where appropriate, and image-guided injection or referral only when clinically indicated. Consultant physiotherapist Bob Chandran reviews the latest MSK literature and updates our clinical protocols routinely.
Further reading
Recognised UK and international clinical guidance relevant to Thumb Base.
Frequently asked questions
Is thumb-base injection painful?
The joint is small, so most patients feel a brief pinch. Ultrasound guidance lets us minimise passes.
Book a consultation for thumb base
Consultant physiotherapist Bob Chandran (Boobala Chandran Subramanian) leads every clinic. Self-refer today.
Getting here
Easy to reach — and easy to park
We're in Elms Parade, Botley, just a few minutes from Oxford city centre with excellent transport links.
Free parking
2 hours free, right outside
Park directly in front of the clinic in the Elms Parade car park — 2 hours free for patients, no app or ticket needed for short visits.
From Oxford Railway Station
Approx. 1.5 miles (8 min by taxi, 20 min walk). Head west on Botley Road, continue straight across the A34 flyover into Westway, then turn right into Elms Parade.
Nearest bus stop
Elms Parade (Stop B1) — directly outside the clinic. Served by routes 4, 4A, 4B and 4C from Oxford city centre (every 10–15 min).
By car
Junction 8/9 of the A34, exit toward Botley. Postcode OX2 9LG for sat-nav.
Expert MSK care in Oxford
Oxford Injection Clinic is the specialist musculoskeletal service of GB Clinic Oxford, an independent physiotherapy and interventional MSK clinic based in Botley. Our consultants and advanced practitioners assess, scan and treat the full spectrum of joint, tendon, ligament and nerve problems — from acute sports injuries to long-standing arthritis. Every clinician is HCPC-registered and holds post-graduate qualifications in diagnostic ultrasound, injection therapy or advanced musculoskeletal practice.
We believe the fastest route to recovery is an accurate diagnosis on day one. That is why every consultation includes a full history, a hands-on clinical examination and, where useful, a real-time high-resolution ultrasound scan. If an ultrasound-guided injection is likely to help, we can usually perform it in the same visit — no separate trips, no waiting weeks for imaging.
Evidence-based, patient-led
Not everyone needs an injection. Our clinicians follow NICE, BOA and international best-practice guidance to decide when injections, shockwave therapy, hydrodilatation, barbotage or a structured loading programme is the right next step. Where surgery is genuinely the best option we say so, and we can refer to trusted orthopaedic and pain specialists across Oxford, London and the Thames Valley.
Patients travel to see us from Botley, Summertown, Headington, Cowley, Iffley, Abingdon, Witney, Kidlington, Bicester, Didcot, Wallingford, Wantage, Wheatley, Thame, Woodstock, Chipping Norton, Banbury, Henley-on-Thames and Reading. Same-day appointments, evening slots and Saturday clinics are usually available, and free on-street parking is right outside the clinic.