The thumb is a very important part of the hand, it enables us to pick things, write, and use our phones easily. However, because of how versatile our thumbs are, they are prone to some injuries when overworked.
What Causes Thumb Pain?
1. De Quervain Tenosynovitis
This is an inflammation of tendons at the thumb side of the wrist, causing pain at the base of the thumb. It is usually associated with repetitive thumb or wrist movement like when playing video games, texting or playing golf.
This makes tendons rub against each other, leading to irritation and swelling of the surrounding tissue.
A fracture is a broken bone. There are three bones in each thumb, if any of them gets broken by a fall or direct trauma, it can lead to severe thumb pain. Other symptoms associated with a fractured thumb are swelling, deformity, bruising, and a loss of function.
3. Thumb Sprain
The thumb has ligaments supporting each joint, an injury to these ligaments can cause thumb joint pain, weakness, or instability. A sprain can be caused by an extreme bend of the thumb such as sporting activities like skiing where the pole strap catches on the thumb.
In this condition, there may be some pain when trying to write, hold things or attempting to open a door.
At every joint, there is cartilage that covers the surfaces of the bones within, allowing them to be mobile without brushing against each other. With age or injuries, the cartilage in the thumb can begin to wear leading to arthritis. This can cause pain at the thumb joint, stiffness, swelling, weakness, and a decreased range of motion.
5. Carpal Tunnel Syndrome
Carpal tunnel syndrome is one of the most common conditions that can cause pain in the hands. It is caused by increased pressure on the median nerve- a nerve that supplies the thumb, index finger, middle finger, and half of the ring finger. This can cause pain, numbness, weakness or a tingling sensation.
6. Trigger Finger/Stenosing Tenosynovitis
The fingers have tendons that curl them into a fist. Those tendons travel through a sheath. A trigger finger, also known as stenosing tenosynovitis, is a common issue where the tendon catches on the edge of the sheath and the tendon can no longer glide smoothly and sometimes gets stuck. This often causes pain and can result in the finger getting stuck in a curled position.
When To See A Doctor
It’s best to see a doctor if you feel you’ve broken a bone in your thumb, have persistent thumb pain or have additional symptoms like swelling, deformity, instability or inability to move your thumb.
Some tests may be requested in the course of your management. These may include:
- X-Rays to evaluate the bone and joints
- Physical exam including Tinel’s Test (for carpal tunnel syndrome)
- Nerve conduction study to assess nerve function
- MRI to evaluate other tissues such as tendon or ligament.
Treatment is generally targeted at the underlying cause. Here are some treatment modalities for caring for thumb pain:
The PRICE acronym is a popular method used in caring for injuries during the first 72 hours of pain onset.
The acronym stands for:
Protect– Protect the thumb from further injury
Rest– Rest the thumb by avoiding some activities for a while. You can also wear a thumb splint with wrist support or taping.
Ice– Ice helps to relieve pain and reduce swelling
Compression– Use a compression bandage to reduce swelling
Elevation– Position the thumb above chest level to reduce swelling
Non-steroidal anti-inflammatory drugs (NSAIDs) like Ibuprofen and Naproxen are prescribed to reduce the swelling and relieve pain. Sometimes a doctor may suggest an injection of steroidal anti-inflammatory drugs also known as corticosteroids to reduce swelling and reduce pain.
Physical therapy plays a major role in the healing process of many thumb conditions. It helps to improve functionality, range of motion, and to lower pain.
Depending on what the underlying cause is, your doctor may send you to the physical therapist who will then carry out an assessment of the condition and can help pick out an appropriate recovery plan.
Here are some treatment options with physical therapy:
- Thermal modalities like ice or infrared may be used to relieve pain and increase range of motion.
- A nerve stimulator may be used to relieve numbness and tingling sensation caused by compression of the median nerve.
- Exercises can be recommended to strengthen weak muscles.
- Deep tissue massage can be done to relieve the pain and speed up the healing process.
For some cases like a fracture, ligament rupture, or carpal tunnel syndrome, your doctor may suggest surgery. This is to ensure a precise and predictable recovery.
It can be to openly align and fix the broken bone or ligament or to release a band of tissue that’s compressing a nerve.
- Try to involve your other fingers when typing on your phone. Extreme reliance on just your thumb can lead to some of the aforementioned conditions.
- Exercise and stretch your hands from time to time
- Position your arms properly when writing or typing. The forearm, wrist, and hand should be well supported and aligned straight to avoid tension.
- Report early to your doctor if you feel any discomfort in your hands.
The thumb is one of the most important functional parts of the hand. It is because of its importance, overall mobility, and position on the hand, that there is a tendency for increased use and making it prone to injury.
If you have thumb pain, you can try to use the PRICE principle and discuss your symptoms with your doctor. Remember to follow your doctor’s recommendations.
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