There are numerous small joints affecting the hand and wrist. Any one of these can become arthritic and painful. The most commonly affected joints are the small joints in the fingers and the joint at the base of the thumb. Treatment options include conservative options such as splinting, pain relief tablets and steroid injections. Surgical options include denervation of the joint (removing the nerves causing pain), partial or complete removal of the joint, a joint replacement or fusion (stiffening) of the joint. Each joint and each individual should be considered in their own merits following a thorough consultation. I will therefore only discuss base of thumb pain on the next page.