Injection of Botulinum Toxin for Thumb Carpometacarpal Arthritis

Launched by RHODE ISLAND HOSPITAL · Aug 10, 2023

Keywords

ClinConnect Summary

This clinical trial is studying the use of botulinum toxin, commonly known as Botox, as a potential treatment for pain and arthritis in the thumb joint. Currently, people with thumb joint pain often receive steroid injections to manage their symptoms, but these injections don't always work and can have side effects. The researchers aim to see if Botox, which works differently than steroids, can provide relief for patients suffering from thumb joint pain when other treatments have not helped.

To participate in the trial, you need to be an adult over 18 years old who has been diagnosed with arthritis in the thumb joint and has experienced pain for at least three months despite trying other treatments like pain medication and splinting. Unfortunately, individuals with severe arthritis or other specific hand conditions, previous significant injuries to the thumb, or certain health issues will not be eligible. If you join the study, you will receive injections of Botox and be monitored for safety and effectiveness, helping to determine if this could be a new option for treating thumb arthritis in the future.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Adult patients (\> 18 years old) with a diagnosis of thumb CMC OA
• • Diagnosis of thumb CMC OA
• • History, clinical exam, and radiographic findings, as done in prior studies on this topic.
• • Subjective: thumb or wrist pain at rest or with activity, joint stiffness
• • Exam: basal joint tenderness, decreased mobility, deformity, instability
• • Radiograph: joint space narrowing, subchondral sclerosis, osteophytes, subchondral cysts, Eaton-Littler stage.
• • Failed conservative management with oral pain medication and splinting for at least 3 months.
• Exclusion Criteria:
• • Severe osteoarthritis (Eaton-Littler stage 4) or too large osteophytes to allow for injection into the joint space Inflammatory arthritis
• • Any concomitant hand conditions (i.e. carpal tunnel, trigger finger, etc)
• • Prior significant hand trauma related to the thumb or first CMC joint
• • Prior intervention or hand surgery
• • Patients with fibromyalgia or complex regional pain syndrome (CRPS)
• • Pregnant and breastfeeding patients will also be excluded. We also will exclude individuals attempting to conceive or who could become pregnant within 6-months of treatment.