The base of my thumb metacarpals hurt. they hurt more with gripping. what could it be? they have been hurting for years but has gotten progressively worse. it hurts down to the carpals and i can make it hurt with manipulation

Statistically, : Statistically, you are likely to be a 50-year-old woman with symptoms in your non-dominant hand. These symptoms are classic for arthritis at the base of the thumb. (basilar joint = carpometacarpal joint = trapeziometacarpal joint) 25% of women and 17% of men will have arthritis in this area by age 70. If you are not in this demographic, there can be other causes. After an injury, the beak (aka volar oblique) ligament can be torn. This should be repaired if there is no underlying arthritis. Ganglion cysts can occur in this area. Less commonly, the symptoms can be referred from scaphoid fractures, scapholunate ligament injuries, dequervain's tenosynovitis, or skier's thumb. An evaluation by a hand surgeon can be quite helpful. I don't always get x-rays if i know it is arthritis and we are not planning surgery. Otherwise, i would get x-rays.

When : When we studied thumb base arthritis (trapeziometacarpal arthrosis), we found that 94% of women and 80% of men over age 80 had it. (see below) in other words, thumb base arthritis is like like grey hair: if you live long enough you get it. This fact tells me that most people adapt well to it and can depend on their hands even as the arthritis advances. We wish we had a way to slow, stop or reverse arthritis, but we're not there yet. We have treatments that manage symptoms (palliative treatments) such as splints, injections, and pain medication and we have reconstructive/salvage procedures where we remove one of the bones of the diseased joint. Keep in mind that cortisone injection is at best like an Aspirin that lasts a few months and the existing data suggest it may not be better than a placebo injection. Sodha s, ring d, zurakowski d, jupiter jb. Prevalence of osteoarthrosis of the trapeziometacarpal joint. J bone joint surg am. 2005 dec;87(12):2614-8.

Arthritis : Arthritis of the base of the thumb is extremely common, especially in those over 50. It is osteoarthritis from wear and tear--this is the price we pay for having a thumb that is so mobile. I would suggest seeing a hand surgeon. In its early stages, you may well receive relief from a steroid injection to the joint. If this doesn't work, there are several very reliable operations to treat this, but i almost always try non-surgical methods first. Good luck!