Thumb pain - is it dangerous?

introduction

The thumb (Pollex) is the first finger of our hand and has a very special meaning for people, as it is essential for grasping. Due to the high strain on the thumb, thumb pain is particularly severe; they can be very limiting in everyday life.

What other symptoms can I experience with thumb pain?

In addition to the pain in the thumb, there may be various accompanying symptoms:

• SMS thumb:
  The thumb is initially pulled, which then leads to more and more pain and immobility of the thumb. Swelling or reddening is not to be expected since the pain is caused by the inflammation of a tendon.
  
• Rhizarthrosis (arthrosis of the saddle joint):
  There is pain under stress, especially grasping movements or opening a bottle lead to severe pain. After prolonged exercise, swelling in the area of ​​the inflamed thumb joint can occur.
  
• Ganglion: '
  In addition to the pain in the thumb, there is a very large swelling in the thumb area. Movement pain or numbness may occur.
  
• Fracture:
  There is severe pain, swelling, and bruising in the area of ​​the thumb. Rarely, numbness can occur.

Numbness of the thumb

The skin and muscles of the hand are supplied by three major nerves.
The radial nerve gives the outside of the thumb and the adjacent back of the hand the sense of touch, while the median nerve is responsible for the inside of the thumb and the adjacent half of the palm.

For this reason, it is important to know which area of ​​the thumb is numb or painful. In most cases, the tip and the inside of the thumb are affected, suggesting damage to the median nerve.

Numbness is a subjective sensation that is perceived by those affected as extremely uncomfortable. This can occur in addition to pain in the thumb and hand area and radiate down to the forearm or even the upper arm and shoulder. A feeling of numbness can be an indication of nerve damage and requires thorough medical diagnosis.

Numbness in the hand area is often the result of carpal tunnel syndrome. This results in an impairment of the nerve by narrowing its path through the carpal tunnel of the wrist. This usually arises as part of a mechanical overload or inflammation of the anatomical structures running here, which lead to tissue swelling. The subsequent damage to the nerve then typically results in pain, sensitivity disorders or numbness and possibly weakness of certain muscle groups in the hand.

Read more on the topic: Carpal tunnel syndrome

Causes of thumb pain

Pain in the thumb can be attributed to various causes.

• Accidents and falls can lead to injuries to bony structures, tendons and ligaments.
• A common cause is osteoarthritis of the thumb saddle joint and / or metacarpophalangeal joint caused by wear.
• Overuse of the thumb in the context of extraordinary smartphone use can result in the image of a cell phone thumb or SMS thumb.
• Other possible causes of thumb pain include gout,
• a carpal tunnel syndrome that radiates into the thumb,
• tendinitis and
• for example a ganglion (transom).

Overload of the thumb

It is interesting, however, that everyday activities such as texting or writing WhatsApp put more and more strain on the thumb and therefore tend to become painful. This phenomenon is often referred to as the SMS thumb.

The pain in the thumb comes from the fact that the movement of scrolling on the phone or typing a message is not natural for the thumb. Frequent thumb stretching puts strain on the muscles in the thumb.
Therefore, frequent cell phone use can lead to inflammation of the tendons. The tendons mostly belong to the extensor muscles of the thumb, such as the Extensor longus muscle or Extensor brevis muscle.

However, these pains do not appear suddenly, but rather slowly announce themselves. It is therefore particularly important not to ignore the body's first warning signals.
Usually there is an uncomfortable pulling of the thumb at first, then there is slight pain in the thumb and later every grabbing becomes a torture, as the eyes are then already inflamed.

Read more on the subject at: Tendinitis in the thumb

Cell phone thumb or SMS thumb

The cell phone thumb, also called SMS thumb, is a disease that is becoming more and more common. Excessive strain on the thumb muscles, especially on one side with the dominant hand, leads to overload. The extensor muscles of the thumb in particular are overloaded.

Frequent consequences are tendinitis in the thumb and acute joint inflammation in the saddle or metacarpal joint. In the long term, degenerative changes such as osteoarthritis are favored.

To prevent a cell phone thumb, it is advisable to relieve the thumb every now and then and to use several fingers when typing.

Tendovaginitis de Quervain causes pain in the thumb

Tendovaginitis de Quervain, also simply called Quervain's disease, is a special form of tendon sheath inflammation (tendovaginitis). This leads to an inflammation of the so-called first tendon compartment, through which the tendons of two muscles of the thumb that originate on the forearm run.

Repeated heavy loads, often as part of a desk job, can lead to inflammatory changes in a tendon sheath. The tendinitis in the area of ​​the tendon sheaths of the thumb muscles is known as De Quervain's stenoscopic tendovaginitis.

In most cases, the cause of this is an overload of the two tendons due to frequent abduction. This is the spreading of a part of the body away from the center of the body, i.e. in this case the spreading of the thumb away from the palm of the hand. However, a genetic predisposition also seems to play a role.

A typical group of patients is represented by mothers who often use a strong splaying of the thumb when holding the child. The disease can also occur with extremely frequent typing on the mobile phone.

As with other forms of tendonitis, de Quervain's tendovaginitis manifests itself as an intense stabbing or pulling pain radiating over the tendon in the area of ​​the wrist, below the thumb or down to the forearm.
These occur mainly when holding and gripping firmly, but also when moving the thumb in general. That being said, the inflammation may show up as redness and swelling of the affected area. If tendovaginitis is severe, those affected often describe noticeable and audible rubbing.

The treatment of Quervain's disease is similar to that of other tendonitis. First and foremost, taking an anti-inflammatory drug, i.e. an anti-inflammatory drug such as ibuprofen or diclofenac, as well as immobilizing the tendon or muscle are important. To relieve the inflammation, the affected area should also be cooled and, if necessary, cortisone injected. If these measures do not lead to the healing of the tendovaginitis, surgical splitting of the tendon sheath can be successful.

Read a lot more information on this topic at: De Quervain's tendovaginitis

Carpal tunnel syndrome causes thumb pain

The carpal tunnel syndrome is a complex of symptoms caused by an anatomical tightness in the so-called carpal tunnel. Among other things, a nerve, the Median nerve. Compression of the median nerve in carpal tunnel syndrome causes nocturnal pain in the thumb, index and middle fingers as well as sensory disorders such as numbness and tingling in the early stages.

Massaging or shaking the hands typically relieves symptoms quickly. As the disease progresses, the strength of the thumb muscles decreases. This means that nocturnal thumb pain in particular can be an early sign of carpal tunnel syndrome.

Find out more at: Carpal tunnel syndrome

Osteoarthritis of the thumb

Osteoarthritis is a degenerative joint disease caused by joint wear and tear. It is an incurable disease in which cartilaginous structures in joints perish.

A common form of osteoarthritis is Rhizarthrosis in the thumb saddle joint. In addition, osteoarthritis can occur in the thumb joint and rarely in the thumb joint.

In addition to pain in the joint, those affected suffer from increasing restricted mobility and instability in the joint. They lose strength over time.

Rhizarthrosis

Another cause of thumb pain can be a disease of the thumb saddle joint.
The thumb saddle joint is at the transition from the carpal bones to the first finger. If osteoarthritis develops in this joint (Rhizarthrosis), this is expressed by severe pain. The pain occurs mainly when moving, for example when trying to grab an object with the thumb.

The cause of joint wear lies in the anatomy of the thumb saddle joint. The thumb is the most flexible of our fingers. Depending on the movement, however, the thumb joint can be in an extremely unfavorable position. The two joint surfaces then no longer interlock properly and rubbing movements occur that grind or deform the joint surface. This deformation then leads to the fact that both joint surfaces no longer interlock properly, resulting in wear and tear and pain in the thumb, which becomes increasingly severe, especially when moving.

Read more on this topic at: Saddle joint pain

Gout on the thumb

The metabolic disease gout is caused by an increased uric acid level in the blood. The salt in uric acid is deposited in the joints in the form of uric acid crystals and causes painful attacks of gout.

An acute gout attack is most common

• the metatarsophalangeal joint,
• but also ankle,
• Tarsus,
• knee
• as well as wrists and fingers.
• The metatarsophalangeal joint of the thumb is often affected by an acute attack of gout.

The symptoms are severe pain, severe reddening and swelling due to the formation of an effusion, and occasionally even systemic signs of inflammation such as fever and general malaise.

Learn more at: What is gout and what can you do about it?

Ganglion on the thumb

Another cause of pain in the thumb can be a so-called ganglion (also known as the overbone). A ganglion is a fluid-filled protrusion of a joint capsule or tendon sheath.

The transverse legs often appear close to the joint and not infrequently in the area of ​​one of the thumb joints. This benign change can cause severe pain and, depending on its size and location, significantly limit joint mobility. A ganglion is usually visible from the outside and is plump and elastic.

The pain comes from the constriction of a nerve. If the nerve is completely constricted, the thumb can even feel numb. However, this is very rare.

Read more on this topic at: Ganglion on the finger

Fracture of the thumb

As with any bone in the body, if the thumb falls or is subjected to direct force, bones of the thumb can break.

In the Bennett fracture it is a broken bone that runs from the base of the first metacarpal bone into the thumb saddle joint. This is a fracture in the capsule of the thumb saddle joint, which then leads to a dislocation (dislocation) of the thumb. As a result, there is severe pain and swelling in the area of ​​the thumb.

The break is typically caused by an axial direct or indirect force applied to the thumb on the hand, for example if the hand falls. The dislocation fracture is always treated surgically.

In the Winterstein fracture if there is a fracture outside the joint, it is an oblique fracture of the first metacarpal bone near the base. In the event of an irrelevant displacement of the fracture, there is the option of conservative therapy using a plaster splint. Displaced fractures are typically surgically corrected.

In general, breaks or tearing of ligaments in the area of ​​the thumb always lead to severe pain, usually associated with swelling or bruises. The mobility of the thumb is restricted or not possible at all.

How dangerous is thumb pain?

How dangerous pain in the thumb is depends largely on the cause of the pain. If the pain is caused by overloading the thumb, it should go away on its own by taking care of yourself and resting. If the pain occurs over a long period of time or if the pain is particularly severe, the cause should be clarified.

If the pain is acute as a result of trauma, i.e. a fall or accident, it can also be a fracture. Then you should definitely see a doctor.

Therapy for pain in the thumb

Depending on the cause of the thumb pain, there are various therapies to choose from.

SMS thumb:
In the beginning, it usually helps to rest and sometimes a splint or bandage of the thumb.
In worse cases, however, only an operation will help. During this operation, the tendon compartment of the thumb extensor is cut. This immediately causes the thumb to relax. The thumb can be used again almost immediately.

Rhizarthrosis:
Therapy is more difficult here. At the beginning you can still try to treat joint wear conservatively. First you have to protect the joint, wear a splint as often as possible and take anti-inflammatory medication. Acupuncture or mixed corticosteroid injections can also help.
In the advanced stages usually only an operation will help. In young patients, the joint is often stiffened, i.e. one Arthrodesis. The classic therapy, however, is resection arthroplasty. The worn bone (Trapezium) removed and replaced with a bundle of tendons. The procedure is carried out on an outpatient basis and after 6 weeks the thumb should be fully operational again. The only disadvantage of the therapy is that the thumb cannot develop the same strength as it did before the operation. Instead, the pain in the thumb disappears.

These home remedies can help relieve thumb pain

For thumb pain, which is accompanied by swelling, reddening, impaired joint function and movement-dependent pain, home remedies such as

• a quark envelope,
• Cooling compresses and
• Ointments with propolis can be applied.

For joint pain, over-the-counter ointments with one of the active ingredients diclofenac or ibuprofen can be applied locally and relieve inflammation and pain. Anti-inflammatory pain medication in the form of tablets can also be taken.

• Ginger,
• Apple Cider Vinegar,
• Turmeric,
• Honey and
• Cinnamon are home remedies that can be ingested with food and are said to have both anti-inflammatory and antioxidant effects.

If the symptoms do not improve or even worsen, the advice of a doctor is strongly recommended.

Classification of pain according to location on the thumb

Roughly speaking, the thumb consists of the movable end links and the ball of the thumb. Depending on which portion is overloaded or injured, the complaints appear in different places.

Thumb joint pain

The thumb contains a total of three joints, which can cause pain in the event of illness or injury to the joint structures. The most common cause of pain caused by one of the thumb joints is osteoarthritis of the thumb saddle joint. This is a degenerative disease of the joint that connects the thumbbone of the metacarpal with the polygonal bone of the wrist. The reason for the pain is that the destruction of the cartilage of the affected joint causes the bones to rub against each other. The saddle thumb joint can also cause pain if the joint's capsule is damaged. This can happen as part of osteoarthritis or due to an injury and also cause massive pain.

The metatarsophalangeal joint, which connects the metacarpal thumb bone with the thumb bone (proximal phalanx) can also cause pain. This can also be osteoarthritis of the joint. An injury in skiing is typical of an injury to the metacarpophalangeal joint of the thumb.If the thumb gets stuck in the ski pole loop, the joint capsule of the metacarpophalangeal joint and the neighboring tendons are often injured. The thumb joint or the tendons in the vicinity can also be injured in the case of cuts and other sports injuries.

Read more on the subject here Pain in the metatarsophalangeal joint.

Finally, there is the thumb joint, which can also lead to pain in the event of injuries or illnesses. A common injury to the thumb joint is the severing of the tendons of the thumb. Severing the extensor tendon of the thumb can cause severe pain. The mobility of the thumb is also severely restricted in such an injury.

In summary, all joints of the thumb can be responsible for the pain. The treating doctor can best find out which cause and which joint are affected. A detailed anamnesis, physical examination and the implementation of imaging methods can usually find the cause and start a suitable therapy.

Pain in the metatarsophalangeal joint

The metacarpophalangeal joint of the thumb is the joint between the first metacarpal bone and the phalanx of the thumb that is close to the body. The hinge joint is stressed during gripping and turning movements and can cause pain for various reasons.

Possible causes of metatarsophalangeal joint pain include arthritic changes, an acute attack of gout, rheumatoid arthritis, and psoriatic arthritis. Carpal tunnel syndrome can also cause pain that radiates into the thumb.
Acute inflammations, sports injuries and accidents, a cell phone thumb and changes such as a ganglion are also possible causes.

Pain in the ball of the thumb

The ball of the thumb is a swelling of the muscles on the inside of the hand, which is formed by a number of muscles and is essential for holding and grasping objects. A total of four different muscles are involved in the formation of the ball of the thumb. Different diseases can cause pain, which occurs at the ball of the thumb and can be extremely uncomfortable.

In addition to pain that occurs due to an overload of the muscles in this area, the thumb saddle joint osteoarthritis is the most common cause of pain that occurs at the ball of the thumb. Usually, an osteoarthritis of the thumb saddle is noticeable with pain on the ball of the thumb. Increasing pain when grasping can therefore be an indication of osteoarthritis in the thumb saddle joint.

Your own behavior and habits can also lead to severe pain at the ball of the thumb. Frequent text messages or incorrect positioning of the ball of the thumb on a PC mouse can cause pain, which can be very uncomfortable and is often felt in the ball of the thumb. Changing the position of the hand and reducing the strain on the ball of the thumb can usually help in these cases.

Inflammation of the tendons or the tendon sheaths, for example in the context of rheumatoid arthritis, can cause problems in the ball of the thumb. Diseases such as rheumatism can also cause pain in the ball of the thumb. The regression of the muscles of the ball of the thumb as part of the disease can quickly cause pain in the area. Furthermore, an inflammation of the joints near the ball of the thumb can trigger a sensitivity to pressure which occurs on the ball of the thumb.

If the muscles that mainly form the ball of the thumb are damaged, for example in the context of a sports injury, and a muscle fiber rupture may have occurred, this can also be responsible for discomfort in the ball of the thumb.

Finally, certain activities such as the use of a screwdriver can locally irritate the ball of the thumb so much that movements and pressure on the ball of the thumb are painful.

Read more on the topic: Pain in the ball of the thumb

Pain in the wrist of the thumb

The thumb joint is the joint that connects the two bones of the thumb (proximal phalanx with distal phalanx).

In addition to osteoarthritis, which can occur in all joints, including the thumb joint, injuries are the main cause of pain that emanates from the thumb joint. In particular, cuts and crush injuries are common causes of pain in this area.

In addition to the thumb joint, which can be damaged, its capsule or nearby ligaments and tendons can also be injured and cause pain. Often, for example, there is also an injury to the extensor tendon of the thumb, which runs at the top of the thumb. If the structures of the end phalanx of the thumb are injured, the pain is usually very intense, as the area is very well supplied with nerve endings.

Read more on the topic: Thumb joint pain

Pain in the top of the thumb

Pain at the top of the thumb is painful sensations in the area above the wrist of the thumb. Pain at the top of the thumb can also occur in the nail area.

Depending on the cause of the pain, the quality of the pain can vary, occasionally tingling, knocking and numbness at the tip of the thumb. Possible causes are injury in the course of an accident, overuse, joint inflammation that radiates, or tendinitis in the thumb.

Thumb nail pain

The thumb nail can also be responsible for thumb pain. Injury to the thumbnail is common due to cuts or crush injuries. In the case of crush injuries (example: hammer on thumbnail) there are usually additional bruises under the nail, which can be very painful due to the pressure generated. These should therefore be relieved by the treating doctor with one or two holes in the nail. Even with cuts, the nail can be affected and cause pain. The nail itself is not supplied with nerves and therefore does not hurt if injured. However, when the nail bed is injured, as is often the case with cuts, severe pain occurs.

A common cause of a painful thumbnail is an inflammation of the nail bed. This painful reaction of the body is caused by bacteria that multiply under the nail and thus cause inflammation.

Tumors on the nail can also cause severe pain in the region. An indication can be a change in the shape of the nail and the growth of the nail.

Incorrectly cutting the thumbnail can also cause pain. The area of ​​the thumb that rests on the nail can easily become inflamed if it has not been carefully cut, leaving sharp areas that irritate the surrounding skin and lead to pain.

Wrist pain

Pain in the wrist and thumb (especially the thumb saddle joint) can have various causes. On the one hand, there is the possibility of traumatic injuries to the muscle ligament apparatus or the bony structures. Bruises in particular are common here. Likewise, symptoms of overload in the saddle joint of the thumb are not uncommon during manual work. The pain is more acute, so it is short-lived.

However, if the pain persists over a longer period of time, i.e. for months to years, the symptoms may be symptoms of osteoarthritis of the saddle joint of the thumb. This disease, also known as rhizarthrosis of the thumb, is mainly characterized by pain, which occurs at the transition between the wrist and the first metacarpal bone, depending on the load and often also depending on the weather. The pain can typically be provoked by turning movements, such as when opening a bottle. After heavy exertion, an activation of the rhizarthrosis can occur, which is noticeable in an increase in pain, as well as swelling and redness of the joint. Since those affected then try to protect the joint, if the symptoms have persisted for a long time, the thumb muscles will shrink and, consequently, become weak.

Almost all patients affected by rhizarthrosis of the thumb are female. Around 80% of all women over 40 years of age are affected by the disease in various forms. This is due to a congenital growth disorder of the joint, which results in an inclined position of the saddle. This has to do with the fact that the saddle joint, which makes our hand what it is today, was only created about eight million years ago and is therefore quite young in evolutionary terms. To put it simply, he simply didn't have time to develop sufficiently.

How is the diagnosis of thumb pain made?

In order to make a diagnosis of why there is pain in the thumb, the doctor should first refer to the conversation (anamnese) to find out whether there may have been cases of rhizarthrosis in the family. Palpation, that is, feeling the thumb, can also be helpful. However, it is best to take an X-ray or CT scan to identify the exact cause of the pain.
The Finkelstein test also helps with an SMS thumb. Here the thumb should grip an object; in the case of a very advanced inflammation, this can lead to a crunch in the tendon compartment.

Prognosis for thumb pain

The prognosis for pain in the thumb is usually very good.
With the so-called SMS thumb, the pain automatically disappears again with initial rest and an operation is only necessary in the final stage, which is then usually crowned with success.
The removal of an upper leg also works very well in most cases.
Resection arthoplasty is also a promising operation. Over 85% of all cases no longer have any problems with thumb pain after the operation. Although the patient has to wear a cast for 2 weeks and then a thumb splint for 4 more weeks, the other fingers can be used after the operation without any problems.

Prophylaxis - prevent the sore thumb

There is no real prophylaxis to avoid pain in the thumb.
The SMS thumb is of course to be avoided by careful use of the mobile phone. However, if the pain arises due to an excess leg or a rhizarthrosis, there is little that can be done to prevent it. Especially professional groups who use the thumb a lot to pack objects have an increased risk of developing rhizarthrosis.