The Thumb is a wonderful creation in our body, which is used so much in a day-to-day life that it loses its importance. Thumb imprints are taken as a proof of identity till now. It is not until thumb start hurting that we realize its true value. There are numerous causes, which may result in thumb pain.
What Is Thumb Pain?
- Any damage or injury of the soft tissue and bones, which forms the thumb can result in severe pain in the thumb joint.(1)
- Thumb pain can be generated from disease or injury of the bones, joints, tendons, nerves, muscles, connective tissues, skin, or even the nails.
- Pain in the thumb may be associated with spasm and joint stiffness. The associated symptoms may be constant or variable but they are aggravated usually with movement of the thumb.
- The pain in the thumb can be described as a sharp, dull, burning, or throbbing pain, which varies in intensity ranging from moderate to extremely severe.
- In few cases pain felt over thumb is a referred pain. The pain felt in a thumb may be caused by the disease or injury of the spinal cord or pinched nerve at shoulder, elbow or wrist.
- Thumb Pain can be unilateral or bilateral depending on the cause of the pain.
What Can Cause Thumb Pain?
Listed Below Are 8 Medical Conditions That Can Cause Pain In The Thumb:
- Thumb Pain Due To Osteoarthritis: This is one of the most common causes of thumb pain. Osteoarthritis affects the interphalangeal joint and metacarpophalangeal joint resulting in chronic thumb pain. The pain in the thumb is associated with joint deformity caused by Osteoarthritis.(2)
- Thumb Pain Caused By Rheumatoid Arthritis: Rheumatoid arthritis is an inflammatory joint disease that mostly affects smaller joint.(3) The pain is often spread with deformity and similar changes in other fingers are noted as well.
- Bowler’s Thumb Resulting in Thumb Pain: This is a painful condition of the thumb caused by continuous pressure or compression of the digital nerves. The pinch or irritation of the nerve causes abnormal sensory and motor sensation. Sensory symptoms are tingling and numbness, while abnormal motor symptoms are weakness of thumb muscles resulting in difficulties in flexion and extension. This injury is usually caused due to overuse of the hand and particularly movements of the thumb.1Bowler’s thumb is observed in individuals playing sports like bowling, which requires the player to insert the thumb into the hole in the ball and grip the ball.
- Thumb Fracture Resulting in Painful Thumb: Thumb is the most used finger in hand and coordinates its movement with other four fingers and hand. A Thumb fracture is not that common when compared to other fingers of the hand. A fracture at the base of the thumb near the wrist is potentially serious. Fracture of the phalanges of bone of the thumb causes severe thumb pain.
- Sprained Thumb Resulting in Pain in Thumb: This is a painful condition of the thumb, which is caused as a result of rupture of the ligaments or cartilage of the thumb.2
- Thumb Pain Caused Due To Thumb Dislocation: Dislocation of thumb is rare but seen following sports injury or automobile accident. Dislocation may be associated with fracture and results in deformity and severe thumb pain with any attempt to move thumb.3
- Thumb Pain Caused By Bennett’s Fracture: Bennet’s fracture causes referred pain to the thumb on same side. Bennett’s fracture is a fracture of the base of the first metacarpal bone at its articulation point to the trapezium. The trapezium forms a joint at the base of thumb with the first metacarpal bone as well as medial articulating surface of the second metacarpal bone.4
- Thumb Pain Caused By Mallet or Baseball Finger: This is a painful condition of the thumb caused by damage to the extensor tendons of the thumb. The tendon damage causes joint deformity. The injury is not common and results when object strikes exactly at the tip of the thumb. The acceleration of the object causes a considerable amount of force at the time of impact resulting in hyperextension of the thumb and finger. The bone of the thumb may get pulled away along with the tendon resulting in an inability to straighten the thumb.5
What Are The Symptoms That Can Occur Along With Thumb Pain?
Depending On The Cause Of The Injury To The Thumb, The Following Thumb Pain Symptoms May Occur:
- Thumb Pain may be accompanied with stiffness of the thumb
- Bleeding and bruising at the painful thumb joint
- Burning sensation around the thumb
- Difficulty moving the injured thumb in the event of Thumb Joint Dislocation
- Warmth or swelling of the thumb
- Discoloration of Thumb if there was a severe and direct trauma to the thumb joint causing sever pain.
- Thumb deformity
Diagnosis Of Thumb Pain
To identify a cause for the Thumb Pain that an individual is experiencing, the treating physician will conduct a detailed physical examination to look at the range of motion of the thumb. Apart from a physical examination, the physician may also order the following tests:
- X-ray of the thumb to identify any fracture as a cause for pain in the thumb
- CT scan of the thumb
- MRI to evaluate soft tissue injury around thumb joint causing pain
- Ultrasound examination
Treatment For Thumb Pain
The cornerstone of treatment for Thumb Pain is to rest the thumb in neutral position until radiological studies are performed to diagnose the cause of the pain in the thumb. Avoid activities that aggravate the symptoms of thumb pain until all the tests are performed. The initial conservative treatments for thumb pain are based on the specific cause of the pain around thumb joint. Thumb splints or thumb braces are also utilized for immobilization to promote faster healing of the thumb. Specific treatments for some of the causes for Thumb Pain are as follows:
- Treatment of Thumb Pain Caused By Osteoarthritis: The basic treatment for pain in the thumb due to Osteoarthritis is use of thumb splints, NSAIDs for pain relief, physical therapy, and in some cases cortisone injections.
- Treatment of Thumb Pain Due To Bowler’s Thumb: The treatment is to avoid the sporting activities until the soft tissue injury is healed. A thumb splint or thumb guard can be utilized to protect the thumb from further injuries. Thumb pain caused by Bowler’s Thumb is treated with anti-inflammatory medications like Motrin or Naproxen.
- Treatment of Thumb Fracture Causing Pain in Thumb: Thumb fracture is treated with close reduction or open reduction depending on type of fracture. The unstable, comminuted or compound fractures are treated by open reduction. Stable non-displaced or hairline fracture of thumb is treated with closed reduction. The movements of the thumb are restricted following fracture reduction using either cast or splint. It takes about 10 weeks for the fracture to heal.
- Treatment of Pain in Thumb Due To Dislocation of Thumb: Thumb Dislocation is mostly treated with closed reduction under sedation of local anesthesia. Following reduction of dislocation the position of the joint is checked with x-ray. Using cast or splint restricts the thumb movements.
- Treatment of Pin in the Thumb Caused By Bennett’s Fracture: Bennet’s fracture is treated depending on type of fracture. Hairline and non-displaced fracture is treated with pain medications and splint. Displaced fracture is treated with closed or open reduction under sedation. The movement of the hand and thumb is restricted by using splinting or casting. It takes about 10 weeks for the fracture to completely heal. A surgical procedure is required for severe cases where there are multiple fractures.
- Translocation of Digital Nerve: The digital nerve is repositioned in different location around the nerve depending on use of the hand and thumb.1
1.Bowler’s thumb treated by translocation of the digital nerve.
De Smet L1, Van Ransbeeck H, Fabry G.
Acta Orthop Belg. 1999 Sep;65(3):367-8.
2.From ‘playstation thumb’ to ‘cellphone thumb’: the new epidemic in teenagers
S Afr Med J. 2009 Mar;99(3):161-2.
3.Thumb carpometacarpal dislocation and open dorsal metacarpophalangeal instability: a variation of the floating thumb.
Couceiro J, Sanchez A, Pernal C, Sanmartin M.
V Arch Plast Surg. 2014 Mar;41(2):190-2.
4.Edward Hallarran Bennett: Bennett’s fracture of the base of the thumb.
J Perioper Pract. 2013 Mar;23(3):59-60.
5.Tendon ruptures: mallet, flexor digitorum profundus.
Yeh PC1, Shin SS.
Hand Clin. 2012 Aug;28(3):425-30, xi. doi: 10.1016/j.hcl.2012.05.040. Epub 2012 Jul 3.
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