Sprain on the thumb

definition

A sprain is an injury to the capsule-ligament-joint apparatus that does not result in bone fractures (Fractures) or articular surface displacements (Dislocations) comes. Like almost all other joints, the thumb joint can of course be affected by a sprain. The sprained thumb joint is particularly often the so-called saddle thumb joint (lat.Articulatio carpometacarpalis pollicis)which is located at the transition from the hand to the thumb.

A broad spectrum ranges from slight sprains, which usually only correspond to a slight overstretching of the ligaments that span and support the joint, to severe sprains, which are often associated with muscle and / or ligament tears. It is therefore important to know that not every sprain is “bad” and it may well be that one variant requires medical treatment while other thumb sprains heal quickly and easily.

causes

The cause of a sprain usually lies in mundane everyday accidents or sports injuries; It's easy to stumble or get stuck and it can happen! Almost always, a force that pushes the thumb further away from the hand than would naturally be possible causes the sprain. This unnatural movement overstretched the ligaments, creating a sprain. In sports injuries, with regard to injuries to the thumb, those sports that work a lot with the hands - for example handball or volleyball - are very risky. If a fast, powerfully thrown ball hits the thumb at an awkward angle, a sprain is almost unavoidable. But even when skiing, it is not uncommon for a fall with an unfavorable fall on the ski poles to sprain the thumb.

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diagnosis

To make a diagnosis, the attending physician will first listen carefully to the patient's description and, above all, ask for details of how the accident happened. This usually already offers the first clues as to what type of injury is behind the problem. Then he takes a close look at the injured hand (and usually also the healthy one for comparison) and feels the injury. An exact localization of the pain is just as important as determining the exact extent of the damage and recognizing any other injury. In some cases, an ultrasound or X-ray examination may be necessary. If there is still no definite finding, magnetic resonance imaging (MRI) is performed. This can be necessary and important in individual cases in order to clearly differentiate other injuries from severe sprains of the thumb.

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Symptoms

Leading symptoms of a thumb sprain are significant swelling, redness, or even a bruise (Hematoma) at the appropriate point, loss of function in the sense of immobility and above all pain. The next paragraph is dedicated to the latter as the absolute key symptom.
In addition to the pain, the loss of function in particular plays an important role for those affected. Not being able to move the thumb fully complicates many everyday movements such as precise gripping and often affects the entire hand.
Almost as important as the question of which symptoms can be identified is the question of which symptoms are missing: if there are no palpable protrusions or displacements, the thumb is almost certainly not broken. The same applies if no abnormal movements are possible.

Pain from a sprained thumb

A sprain is characterized by sharp, pulsating, sometimes excruciating pain. Although no bone has been broken or ligament torn, most patients find the pain extremely debilitating. Therefore it should always be given additional treatment (see treatment) therapy with pain medication can be carried out. The most common is the active ingredient ibuprofen, which belongs to the so-called non-steroidal anti-inflammatory drugs heard and has analgesic and anti-inflammatory effects. If that is not enough, however, a visit to the doctor is definitely advisable: firstly, a more serious injury could be hidden behind the supposed sprain and secondly, a doctor can also prescribe stronger painkillers if necessary. If in doubt, it may be more advisable to take stronger medication than just increasing the dose of over-the-counter pain relievers.

treatment

Initially, a sprain of the thumb - like all other sports injuries - should be treated according to the PECH rule: It is advisable to interrupt any activity immediately (break) and to cool the affected area as quickly as possible (ice). External pressure (compression) - for example through a tight bandage - helps to relieve pain and consistently lying up keeps the emerging bruise and the swelling resulting from the injury as low as possible.
There are various options for further treatment of a sprain of the thumb.It is not possible per se to choose one of the options as particularly effective or the best; rather, the offerings available should guide the selection. After all, even the best treatment method is of little use if it is just not feasible.
Common to all variants is the goal of immobilizing the joint and relieving pain. Medication helps relieve pain, especially in the first few hours to days after the injury. With good immobilization, however, these should soon no longer be necessary. The joint itself can be fixed by taping or connecting (see the following sections) or also with specially made rails, so-called Orthotics. The injured joint should always be fixed in or at least as close as possible to the so-called normal position. This describes the position of the joint that one would take at rest if the joint were not injured. As a result, movements of the rest of the hand and especially the other fingers are normally still possible without any problems. Immobilization is essential after a sprain so that healing can occur. If the healing process does not take place correctly, in the worst case scenario, permanent instability can arise, which can lead to significant loss of function of the thumb.

Taping a sprained thumb

If you decide to immobilize with the help of tape, so-called sports tape from the pharmacy is best. Two strips running in opposite directions are used for the tape bandage ("Reins") Glued diagonally across the wrist to the opposite side. Finally you fix it with another tape on your wrist. If you are unsure about the correct application, it is advisable to have a doctor or physiotherapist (or another trained person) show you the correct technique. The tape should be changed and reapplied about every 2 days.

Bandaging the sprained thumb

Bandaging is also a simple, quick and effective option to immobilize a sprain of the thumb. This is done by wrapping from the wrist up to the extreme end of the thumb and then back in the shape of an 8 around the thumb and wrist. The dressing material should not be wrinkled and should not be too loose. But of course the bandage shouldn't be too tight either. If the thumb begins to tingle, becomes pale or cold, or hurts significantly more than before, the bandage is probably too tight. Now it's time to loosen the old association and reconnect it. Here, too, it can help to have an experienced person show you the right technique.

Healing time

As a rule of thumb, the end point of healing is the state of complete freedom from pain. If nothing hurts anymore, the tissue has probably regenerated again. As a rule, improvement should be seen after about 4 to 6 days and all symptoms should have disappeared after 1 to 2 weeks. However, this may take longer or happen faster depending on the severity of the injury. If the person concerned still feels significant pain a week after the accident, this is an urgent indication to consult a doctor now at the latest - if this has not already happened.

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