Does thumb arthritis keep getting worse over time?

In short

Yes. Thumb arthritis is progressive, so the joint keeps wearing, and Dr. Knight finds the pain usually grows with it. A splint or an injection can ease the pain, and surgery is an option for a badly worn joint. In some severe cases the pain eases on its own, but the joint is still worn.

By The Hand and Wrist Institute Medically reviewed by John T. Knight, MD Reviewed November 4, 2026 Updated November 2, 2026How we write and review

Call (817) 382-6789 to have this looked at, or book online with Dr. Knight.

The joint keeps wearing

Pinch your thumb against your index finger and feel the base of the thumb, where it meets the wrist. That joint is where thumb arthritis most often starts.¹ Arthritis is progressive, which means the joint keeps wearing over time. What changes from person to person is how much it hurts.

Pain does not always follow the x-ray

Dr. Knight finds that as the joint wears, the pain usually grows, especially with gripping, pinching and turning, like turning a key.¹ But the pain and the x-ray do not always match. Some people with advanced arthritis on x-ray have very little pain, and the pain can rise and fall for reasons that are not fully understood.² In some severe cases Dr. Knight sees the pain actually ease. Less pain does not mean the arthritis has gone.

What eases it

You do not have to wait for the joint to wear out. A splint that supports the base of the thumb can reduce pain during activity, and a steroid injection into the joint is an option.¹ Surgical options include fusing the bones of the joint or reconstructing it.² For a badly worn joint, Dr. Knight walks through one surgical option in How does the Mini TightRope suspend the thumb after a trapezial resection?.

Thumb arthritis care in Southlake and Plano, Texas

Dr. Knight treats thumb arthritis at our Southlake office on weekdays and our Plano office on Tuesdays. An x-ray, when it is needed, is taken on site and reviewed with him in the same visit. If surgery is ever the right step, it is done at Legent Surgical Hospital in Plano. More on treatment is on our thumb arthritis page.

In Dr. Knight's words

"Yes, arthritis is progressive. However, in some severe cases the pain actually may lessen. But usually, as arthritis worsens, so does the pain."

When to call us

• Pain at the base of the thumb when you pinch or grip.
• A bump or change in shape at the base of the thumb.
• Trouble opening jars, turning keys or holding a cup.
• Pain that wakes you at night or has not settled with a splint.