Cortisone Injection for Thumb Arthritis
By Mr Gavin Schaller FRCS(Tr&Orth) | Consultant Hand & Wrist Surgeon | Reviewed September 2026
In short: A cortisone injection for thumb arthritis places a corticosteroid into the worn joint at the base of the thumb to calm inflammation and ease pain. The relief typically lasts a few months, sometimes longer, and varies a great deal between people. An injection does not cure the arthritis or rebuild the joint, but it can settle a painful flare and buy comfortable time before other treatments are needed.
What is a cortisone injection for thumb arthritis?
A cortisone injection for thumb arthritis is a small dose of corticosteroid, usually mixed with local anaesthetic, placed into the arthritic joint at the base of the thumb. This joint is the carpometacarpal (CMC) joint, also called the basal thumb joint, where the thumb meets the wrist. When the joint is worn, the lining becomes inflamed and painful, and the corticosteroid works by damping down that inflammation.
The injection is an anti-inflammatory treatment, not a repair. A cortisone injection does not regrow cartilage or reverse the underlying thumb arthritis. What the injection can do is quieten a painful, inflamed joint for a period of time, which for many people is enough to get back to comfortable use of the hand.
How long does a cortisone injection last for thumb arthritis?
A cortisone injection for thumb arthritis typically gives relief for around three to six months, though the range is wide and some people benefit for much longer or much shorter than this. The response depends on how advanced the arthritis is, how inflamed the joint was and how heavily the thumb is used day to day.
Milder or earlier arthritis tends to respond better and for longer, while a severely worn joint may settle only briefly. Some people get many months of good relief from a single injection, others a few weeks, and a small number notice little change. Because the response cannot be predicted precisely beforehand, an injection is often worth trying to see how the individual joint responds.
How quickly does a thumb cortisone injection work?
A cortisone injection for thumb arthritis usually starts to help within a few days to two weeks, as the corticosteroid takes effect. The local anaesthetic mixed with the injection can numb the joint immediately, giving a few hours of relief on the day, after which the pain often returns briefly before the steroid begins to work.
It is common for the thumb to feel a little more sore for a day or two after the injection, sometimes called a steroid flare, before the anti-inflammatory effect settles in. Resting the thumb for the first day or two and using a thumb splint can help the injection do its work.
What happens during a thumb arthritis injection?
A thumb arthritis injection is a quick outpatient procedure that takes only a few minutes. The skin over the base of the thumb is cleaned, and the corticosteroid and local anaesthetic are placed into the joint through a fine needle. The injection may be guided by ultrasound to place it accurately within the small basal joint.
Most people feel a brief sting and a sense of pressure as the fluid goes in. There is no cut and no stitches, and you can go home straight afterwards. The hand can be used gently the same day, and it is sensible to avoid heavy gripping for a couple of days while the joint settles.
How often can you have a cortisone injection in the thumb?
Cortisone injections in the thumb are usually limited to a small number in the same joint over time, commonly no more than two or three in a year, with a gap of at least a few months between them. Repeated corticosteroid injections into a small joint can, over time, weaken nearby soft tissues, so they are used judiciously rather than repeated indefinitely.
If an injection helps only briefly, or if a second injection gives less relief than the first, that pattern is useful information — it usually means the arthritis is advanced enough that a more lasting treatment is worth discussing. The point of the injection is to control symptoms and inform the plan, not to be repeated on a fixed schedule.
When is a cortisone injection the right choice for thumb arthritis?
A cortisone injection is a sensible choice for thumb arthritis when the joint is painful or inflamed and simpler measures have not been enough, and when surgery is either not yet needed or not yet wanted. An injection fits well in several situations:
A painful flare of arthritis that needs settling
Symptoms that a splint and painkillers alone have not controlled
A wish to postpone or avoid surgery for the time being
A need to stay comfortable through a busy period at work or a specific event
Uncertainty about how much of the pain is coming from the basal joint, where a response to injection helps confirm the source
An injection is one part of a wider plan that also includes activity changes, a thumb splint, hand therapy and, where symptoms persist, surgery. NICE guidance on osteoarthritis supports corticosteroid injections as a short-term option when other measures have not given enough relief.
When is surgery better than repeated injections?
Surgery becomes the better option when injections give only brief relief, when the pain is constant and disturbs sleep, or when pain at the base of the thumb is limiting work, hobbies and daily tasks despite non-surgical treatment. At that stage, another injection tends to give diminishing returns, while an operation offers a lasting solution.
The most established operation for the worn-out basal joint is a trapeziectomy, which removes the small arthritic bone at the base of the thumb and gives reliable, durable pain relief. A joint replacement is an alternative in suitable patients. An injection and surgery are not competing choices so much as points on the same path — injections help earlier and milder disease, surgery helps when the joint is worn beyond what an injection can settle.
My approach to injections for thumb arthritis
In my practice a cortisone injection is a useful and low-risk step for thumb base arthritis, particularly for a painful flare or when someone wants to delay surgery. I am clear with patients that the injection treats the pain rather than the arthritis, that the length of relief varies widely and that its effect is often most helpful the first time.
I also use an injection on occasion to guide further treatment. Pain around the base of the thumb can come from more than one joint, and when it is not clear which joint is responsible, placing an injection into one particular joint helps localise the source. If the pain settles well after the injection, that response confirms the injected joint as the main problem and focuses any further treatment — including surgery — on the right target.
I use the response to guide the plan more broadly too. Good, lasting relief means we can manage the arthritis without an operation for now. Brief or fading relief tells us the joint is worn enough that surgery is likely to serve better, and we discuss that openly rather than repeating injections indefinitely.
From October 2026 I consult at London Sports Orthopaedics, 31 Old Broad Street and operate at London Bridge Hospital, as well as Spire Bushey and Pinehill Hospital in Hertfordshire. If thumb pain is holding you back, you are welcome to book a consultation.
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Frequently asked questions about cortisone injections for thumb arthritis
How long does a cortisone injection last in the thumb? A cortisone injection in the thumb typically gives relief for around three to six months, though this varies widely. Some people benefit for a year or more, others for only a few weeks. Milder arthritis tends to respond better and for longer than a severely worn joint. Because the length of relief cannot be predicted precisely, an injection is often worth trying to see how the individual joint responds.
Does a cortisone injection cure thumb arthritis? No. A cortisone injection does not cure thumb arthritis or rebuild the worn joint. The injection calms the inflammation in the joint and eases pain for a period of time, which can be very helpful, but the underlying arthritis remains. For lasting relief once the joint is badly worn, surgery such as a trapeziectomy addresses the problem directly rather than temporarily.
How painful is a thumb cortisone injection? A thumb cortisone injection usually causes a brief sting and a feeling of pressure as the fluid enters the small joint. Local anaesthetic mixed with the steroid numbs the area quickly. Many people notice the thumb is a little more sore for a day or two afterwards, called a steroid flare, before the anti-inflammatory effect settles in and the pain eases.
How many cortisone injections can you have in your thumb? Cortisone injections in the thumb are generally limited to no more than two or three in the same joint within a year, spaced several months apart. Repeated corticosteroid injections into a small joint can weaken nearby soft tissues over time, so they are used sparingly. If injections give only brief relief, a more lasting treatment such as surgery is usually the better next step.
Can I drive home after a thumb injection? Most people can drive home after a thumb cortisone injection, as it is a quick outpatient procedure with no cut or stitches. The thumb may feel numb from the local anaesthetic for a few hours, so it is sensible to make sure you can grip and control the wheel comfortably before driving. Avoid heavy gripping with that hand for a day or two afterwards.
What are the risks of a cortisone injection in the thumb? Cortisone injections in the thumb are generally safe, and serious problems are uncommon. Possible effects include a short-lived flare of pain, a small area of thinned or paler skin at the injection site, a temporary rise in blood sugar in people with diabetes and, rarely, infection. Limiting the number of injections into the same joint reduces the small risk of weakening the surrounding soft tissues.
Is a splint or an injection better for thumb arthritis? A splint and an injection do different jobs and are often used together for thumb arthritis. A thumb splint supports and rests the joint during activity and can be used long term, while a cortisone injection settles inflammation during a painful flare. Many people start with a splint, painkillers and activity changes, and add an injection when those measures are not enough on their own.
What happens if a cortisone injection does not work for my thumb? If a cortisone injection gives little or only brief relief for thumb arthritis, that usually means the joint is worn enough that an injection can no longer settle it. In that situation, surgery such as a trapeziectomy is the more dependable option and gives lasting pain relief. A limited response to injection is useful information that helps guide the timing of an operation.
Mr Gavin Schaller FRCS(Tr&Orth), Consultant Hand & Wrist Surgeon The Schaller Hand & Wrist Clinic About Mr Schaller
This article is for general information only and is not a substitute for a consultation with a qualified clinician. If you have concerns about your hand or wrist, please seek medical advice.
