Osteoarthritis Clinic · Home exercise program

Thumb base osteoarthritis (CMC)

Carpometacarpal joint osteoarthritis

Gentle exercises and simple aftercare to follow at home after your corticosteroid injection. Start slowly, build up as comfort allows, and stop anything that causes sharp pain.

Corticosteroid injectionDepo-Medrol (methylprednisolone acetate)
About this conditionAll patient guides
Reviewed
Reviewed. The exercises, repetition counts, hold times, and order of the exercises on this sheet have been checked by Dr. Mahendira against the clinic's printed handout.
SMH Osteoarthritis Clinic · Thumb base osteoarthritis (CMC) · Corticosteroid injection (Depo-Medrol (methylprednisolone acetate))
Reviewed by Dr. Mahendira against the clinic handout.

Your injection

A long-acting corticosteroid injected directly into the CMC joint to reduce inflammation and relieve pain. It is not a pain reliever. It works by calming the immune response that drives swelling in the joint.

After your injection

What to expect

  • Mild soreness or increased pain at the injection site is normal for 24 to 48 hours (a steroid flare).
  • The Depo-Medrol usually begins working within 2 to 5 days. Full effect may take up to 2 weeks.
  • The injection area may appear slightly swollen or bruised.

First 24 hours

  • Rest your thumb. Avoid gripping, pinching, and heavy lifting.
  • Apply ice wrapped in a cloth for 10 to 15 minutes every 2 to 3 hours to reduce swelling.
  • Keep the injection site clean and dry.
  • Take acetaminophen (Tylenol) as needed. Avoid NSAIDs for 24 hours unless directed.

Days 2 to 7

  • Gradually resume light daily activities as comfort allows.
  • Continue to avoid heavy gripping or repetitive thumb use.
  • Begin gentle range of motion exercises.
  • Wear your thumb splint during activities that aggravate pain.

Important reminders

Limit injections to 3 to 4 per year per joint. Repeated corticosteroid injections may weaken tendons and cartilage over time. People with diabetes should monitor blood sugar closely for 3 to 5 days.

Your exercises

Begin gently after about 48 hours if you are comfortable. Move slowly and stay within a mild, pain-free range. The counts below are a guide for how much to do.

1

Thumb flexion and extension

Bend your thumb across your palm toward the base of your pinky finger, then straighten it fully. Move slowly and controlled.

2 sets of 10 reps, 2 to 3x daily

Avoid forcing into pain.

2

Thumb opposition

Touch the tip of your thumb to the tip of each finger in sequence (index to pinky), then reverse. Form a round O shape each time.

2 sets of 5 cycles, 2x daily

Focus on making a smooth, round O.

3

Thumb abduction (spread)

Place your hand flat on a table, palm down. Slowly move your thumb away from your hand as far as comfortable, then return.

2 sets of 10 reps, 2x daily

Keep fingers flat on the surface.

4

Thumb IP joint flexion

Stabilize the thumb metacarpal with your other hand. Bend only the tip joint (IP) of your thumb, then straighten. Isolates the distal joint.

2 sets of 10 reps, 2x daily

Hold the base of the thumb steady.

5

Flat fist and hook fist

Bend all fingers at the middle joints to form a flat fist (tabletop position), hold 5 seconds. Then curl into a hook fist, hold 5 seconds. Straighten fully.

2 sets of 8 reps, 2x daily

Keeps tendons gliding smoothly.

6

Gentle pinch strengthening

Start after week 2 if pain-free

Pinch a soft foam ball or putty between your thumb pad and fingertips. Hold 5 seconds, then release. Start only when pain-free with the range of motion exercises.

1 to 2 sets of 8 reps, 1x daily

Start after week 2 if pain-free.

7

Wrist flexion and extension

Rest your forearm on a table with your wrist at the edge. Slowly bend your wrist up and down through full range. The wrist influences CMC mechanics.

2 sets of 10 reps, 2x daily

Keep the forearm still.

Exercise guidelines

  • Stop any exercise that causes sharp or increasing pain.
  • Mild discomfort is fine. Sharp pain is not. Use the 0 to 3 rule: stay at 3 out of 10 or below.
  • Apply ice for 10 minutes after exercising if the joint feels warm or achy.
  • Progress slowly. Range of motion first, then strengthening only when pain-free.

Protecting the area every day

  • Use wide, padded grips on pens, utensils, and tools to reduce pinch force on the CMC joint.
  • Open jars with your palm or use a rubber grip pad. Avoid using your thumb to twist.
  • Carry bags on your forearm rather than gripping handles tightly with your fingers.
  • Slide objects across surfaces instead of lifting them when possible.
  • Use lever-style door handles and faucet turners to minimize thumb strain.
  • Avoid prolonged pinching or gripping tasks. Take breaks every 10 to 15 minutes.
  • Use both hands to hold heavier items like books, plates, or cups.
  • Consider adaptive tools: electric can openers, key turners, and built-up utensils.

Thumb spica splint

Wear it as directed, especially during aggravating activities and at night. A well-fitted splint stabilizes the CMC joint and reduces pain.

Tracking your progress

Tick a box each day you complete your exercises, and circle how the area feels.

 MonTueWedThuFriSatSun
Week 1
Week 2
Week 3
Week 4
Pain level today (circle one)
012345678910
0 = none10 = worst
!When to call your doctor. Contact the clinic or seek care if you notice any of the following: Increasing pain, swelling, or redness at the injection site lasting more than 48 hours; Fever above 38C (100.4F), which may indicate infection. Seek care urgently; Numbness, tingling, or loss of sensation in the thumb or hand; Skin changes: lightening, thinning, or a depression near the injection site; Symptoms of high blood sugar in people with diabetes: excessive thirst, frequent urination, blurred vision; No improvement in pain or function after 2 weeks.
This is general information, not medical advice. Your exercises and recovery depend on your own situation, and your clinician will guide you.

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