Pain in the metatarsophalangeal joint

definition

The metatarsophalangeal joint (Articulatio metacarpophalangealis pollicis) forms the transition from the metacarpal to the thumb.

The joint allows flexion and extension of the thumb. Pain in the metacarpophalangeal joint of the thumb can become a burden in everyday life, as the thumb plays an important role in making gripping movements.

There are various causes such as trauma or osteoarthritis (Joint wear) for pain in the thumb joint. The pain can vary depending on the cause and can be pulling, stabbing, pressing or suddenly occurring when moving. If thumb pain persists or recurs, a doctor should be consulted to clarify the cause of the pain in the metatarsophalangeal joint.

causes

On the one hand, pain in the metatarsophalangeal joint can be caused by force (trauma) arise in which the joint is injured.
Second, the thumb is moved by a variety of muscles. If muscles or their tendons become inflamed, this can also cause pain in the joint.

Such an inflammation can develop in the so-called "cell phone thumb", whereby the tendons and the other joints in the thumb as well as the metatarsophalangeal joint can become inflamed due to the one-sided movement of the thumb.

Furthermore, osteoarthritis (Joint wear) Be the reason for pain in the metatarsophalangeal joint. The articular cartilage wears out and causes painful restrictions on movement. The pain in the metatarsophalangeal joint usually cannot be felt at rest.
Osteoarthritis of the metatarsophalangeal joint can also be caused by a previous injury (trauma) that have damaged the joint or bones.

Another possible cause of pain in the metatarsophalangeal joint can be rheumatoid arthritis (chronic polyarthritis). This is a chronic inflammation, which can affect other joints in addition to the metacarpophalangeal joint.

Gout can also be responsible for a painful metatarsophalangeal joint.

rheumatism

Rheumatism or rheumatoid arthritis is a chronic inflammatory joint disease unknown (idiopathic) Origin. It is an autoimmune disease in which the body experiences an excessive immune reaction.

In rheumatoid arthritis, the immune response is primarily directed against the joints, but internal organs can also be affected. The immune reaction continues to destroy the joints, causing pain, swelling and redness.

The joints are mostly symmetrical (so on both sides of the body) affected. In addition to pain in the metatarsophalangeal joint, the little finger joints are almost always affected. In addition, the knee, hand, foot and cervical spine can be painful and inflamed.

Read more about this under How do you recognize rheumatism?

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arthrosis

Osteoarthritis can also cause pain in the metatarsophalangeal joint in rare cases. Osteoarthritis is one degenerative cartilage wear on the affected joint. In contrast to rheumatoid arthritis, arthrosis in the metatarsophalangeal joint is not an inflammatory process. Rather, osteoarthritis is caused by Joint misalignments, strong one-sided burden or increasing joint wear caused in old age.

The fact that osteoarthritis causes pain in the thumb joint is relative, however Rare. From osteoarthritis of the thumb this is usually the case Saddle thumb joint or that Thumb joint affected.

gout

In gout (Uric arthritis) is a metabolic disease in which so-called urate crystals (Uric acid salt) in the joints.
These urate crystals can result from excessive consumption of meat and alcohol, for example.

Thus, gout is primarily a disease of affluence, with most patients also suffering from diabetes mellitus, obesity (Obesity), high blood lipid levels (Hyperlipidemia) or high blood pressure (hypertension) Suffer.

In the event of an attack of gout, stored urate crystals can cause pain in the metatarsophalangeal joint of the thumb and other finger joints in addition to the most common localization in the big toe.

Read more on the subject here Attack of gout

Ligament injury

Ligament injuries are another possible cause of pain in the metatarsophalangeal joint. Strong violence, for example in a sports accident, can cause the thumb to kink in the base joint.

A common injury is the skier's thumb. This results in a partial or complete rupture of the ulnar collateral ligament of the thumb.

Those affected suffer from painful swelling, a bruise in the area of ​​the metacarpophalangeal joint and instability in the joint. Depending on the extent of the injury, conservative and surgical treatment methods are possible.

Concomitant symptoms

In order to differentiate the cause of the pain in the metacarpophalangeal joint, physical symptoms can be crucial. If there is general pain or restriction in movement with swelling and bruising, it may be a ligament tear or a joint injury after an accident or trauma.

The consideration of additional pain in other joints is important for finding the cause. Pain in the metatarsophalangeal joint can also be replaced by numbness or tingling.

In gout, sudden onset and very severe pain in the metacarpophalangeal joint can occur. This does not necessarily have to affect other joints. Furthermore, the pain in the metatarsophalangeal joint caused by gout can usually be felt at rest.

If the pain in the metatarsophalangeal joint is caused by osteoarthritis, there is more likely to be initial pain during movement, which gradually improves. If the osteoarthritis is already well advanced, however, it can also lead to permanent pain.

In rheumatoid arthritis, pain in the metatarsophalangeal joint is rather rare. On the other hand, bilateral (symmetrical) Pain and swelling in the little finger joints and thumb saddle joint.

Often it is difficult to close a fist and the thumb cannot be moved well in the direction of the little finger. Affected patients feel the pain even at rest and usually complain of morning stiffness that lasts for over half an hour. In addition, so-called rheumatoid nodules form after a while (Lumps that can be felt under the skin).

swelling

If there is swelling in addition to the pain at the base of the thumb, this is a sign of an inflammatory process with joint effusion. Capsule and tendon injuries to the metatarsophalangeal joint can also cause swelling and pain.

In addition to the swelling, there is usually also redness. In addition, the general thumb joint can only be moved to a limited extent due to the pain and the hindering swelling.

If, in addition to the pain in the metacarpophalangeal joint, there is also small, non-painful swellings, this can be known as rheumatoid nodules. These can appear on the fingers, toes, hands and elbows and are signs of a rheumatic process.

Pain on the inside

If there is pain on the inside of the thumb joint, a so-called “skier's thumb” can be the cause. It is a tear in the inner collateral ligament at the base of the thumb. Such a crack is usually caused by falling on the thumb, which is stretched outward during the impact.

After such trauma, there are signs of inflammation, swelling, pain, and bruising.
The doctor can check the stability of the metatarsophalangeal joint of the thumb: If the joint is unstable, the joint can "unfolded“Because the securing tape has torn.

Mutual complaints

A bilateral or symmetrical distribution of pain in the metatarsophalangeal joint can, as already mentioned, be rheumatoid arthritis.
Rheumatoid arthritis usually occurs in both hands in the thumb saddle joint, but in rare cases it can also cause pain in the metacarpal joint of the thumb.

Carpal tunnel syndrome, in which the median nerve constricts, can also cause pain on both sides of the thumb. The pain can radiate into the metatarsophalangeal joint. In addition, pain in the middle and index finger is usually typical, some of which are accompanied by tingling and numbness.

Read more on the subject at: Carpal tunnel syndrome

diagnosis

In order to clarify the cause of the pain in the metatarsophalangeal joint, a detailed diagnosis is important. In addition to examining the joints, x-rays, CT and MRI images can show the condition of the metacarpophalangeal joint. In this way, bony or cartilaginous changes in and on the joint can be easily recognized.

Blood values ​​are also of great importance for the diagnosis of rheumatoid arthritis. The so-called rheumatoid factor, anti-CCP antibodies and inflammation values ​​(CRP, BSG) certainly. An increase in these values ​​would support a diagnosis of rheumatoid arthritis, for example.

Read more about this under Inflammatory parameters in the blood

therapy

In general, pain in joints, no matter what the trigger, is short-term with NSAIDs (Ibuprofen, diclofenac) treated. These are supposed to relieve the pain and eliminate any existing inflammation. If there is swelling, the joint must be immobilized and cooled.

The specific treatment for pain in the metacarpal joint of the thumb depends on the cause. Acute relapses in rheumatoid arthritis are treated with glucocorticoids. Long-term therapy is with so-called DMARD (disease-modifying anti-rheumatic drugs) how Methotrexate carried out.

Read more about the here Therapy of rheumatoid arthritis

Acute gout or osteoarthritis are also conservative (without surgical intervention) treated with NSAIDs and glucocorticoids. In the case of ligament tears or joint injuries, immobilization and subsequent physiotherapy or physiotherapy must also be carried out.

Even with carpal tunnel syndrome, pain killers are prescribed in the first few months and immobilization of the wrist with a splint is recommended. If this does not provide relief, an operation must be considered.

If the pain in the metatarsophalangeal joint is caused by a torn ligament, which leads to severe instability of the joint, surgery must also be performed to prevent chronic instability and the associated pain and restricted mobility.

Tape

Kinesio-Tape offers the possibility to individually fix and immobilize the thumb base joint in case of pain. Tape can be used to stabilize joint structures or muscles in the event of injuries and illnesses.

If you do not have any experience with tape, it is advisable to have an experienced physiotherapist show you how to apply tape. You can then buy tape yourself and put it on at home according to your individual needs.

Read more on the subject at: Kinesio tape

bandage

Similar to tape, a bandage is used to fix the metatarsophalangeal joint of the thumb in various diseases of the thumb and hand.
The goal is to reduce possible painful movements in the affected joint.

The bandage is a conservative treatment that gives the diseased joint the opportunity to heal “in peace”.
By preventing painful movements, the pain can be effectively relieved for some people.

homeopathy

Homeopathy can - depending on the cause and in addition to conventional medical treatment - Support the relief of pain in the metatarsophalangeal joint.

Usually 5 globules are taken three times a day. For example, Acidum formicicum or Harpagophythum can be taken for pain caused by arthritic changes.

Luesinum and Tuberculinum residuum are recommended for chronic pain caused by rheumatoid arthritis. If the cause of the pain in the metatarsophalangeal joint is a torn ligament or a bruise, Symphytum is used.

Arncica should be used in the event of an acute gout attack caused by overexertion. If the gout attack is due to consuming too much meat or alcohol, Nux vomica is prescribed. The homeopathic remedies should be taken according to the recommended dosage and potency.

Duration

The duration of the pain in the metatarsophalangeal joint, like the therapy, depends on the cause. Because with diseases like gout, Rheumatoid arthritis or arthrosis pain can occur again and again, these diseases become in bursts always cause complaints.

After trauma, it depends on how strong the injury is. Is it just one strain of the tendons, the complaints can already be felt after adequate immobilization few days disappear. At a Torn ligament it also depends on the severity of the crack. So the treatment can continue until it is completely pain-free Weeks to months drag on.