Inclusion criteria:
Age at least 18 years old
History of pain of first CMC joint during rest or activity that has last for at least 3 months
Have VAS score at least 3 before entering the study
Pain during touch of the dorsal surface of the CMC
OA radiographic evidence of reduced articular space or osteophyte formation (grade 2,3)
No response to common osteoarthritis treatments including oral and topical skin treatments, physiotherapy, exercise therapy, contrast bath
Exclusion criteria:
No patient access for post-intervention investigation due to no personal referral
Patient's willing to use systemic steroids or intra-articular injection other than injectable drugs under the study
Radiographic evidence of severe osteoarthritis (grade 4)
Previous history of first carpometacarpal surgery
History of any intra-CMC1 joint injection in the past six months
Use of physiotherapy modality during the last 3 months
Presence of steroid / lidocain injection contraindication such as sensitivity to these drugs and infection at the site of injection
presence of a risk factor for intra-articular injection such as anti-coagulation use
Poor control of diabetes, coagulation diseases, fractures, rheumatologic diseases, tumors, infections, gout, pregnancy or decision to get pregnant
Severe deformity of the joint
Acute trauma (last 3 months)