Pain and disability related to osteoarthrosis of the trapeziometacarpal joint

Abstract

We investigated the relationship between trapeziometacarpal arthrosis, pain, and upper extremity specific disability by surveying patients from a prior prevalence study. The 456 adult (age 18 or greater) patients from a prior prevalence study were mailed a questionnaire consisting of the full DASH outcome measure as well as additional questions to identify sources of pain other than the thumb, pain in the thumb and whether the patient has received treatment for thumb arthritis. A response rate of 27% was achieved (122 responses). Thumb pain correlated with pain elsewhere in the arm (r = 0.354, p < 0.001), but not with higher grades of arthrosis. The average DASH score was 9.9 [range 0-60.0]. Higher grades of arthrosis (p = 0.013), pain in the thumb (r = 0.602, p < 0.001) and pain elsewhere in the arm (r = 0.665, p < 0.001) were found to be predictors of a higher DASH score. Arthrosis grade explained only 3% of the variation of DASH scores in linear regression modeling, but was included in the best multivariable model-along with thumb pain and pain elsewhere in the arm-which explained 52% of the variation in DASH scores. Higher grades of trapeziometacarpal arthrosis do not correlate with complaints of thumb pain and have a significant, but very limited affect on arm-specific disability, compared to pain elsewhere in the arm.

Keywords: Arthritis; Carpalmetacarpal; Disability; Pain; Thumb; Trapeziometacarpal.