The Importance of Thumbs
Our thumbs are key parts of our hands. Opposable thumbs allow us to use tools and our hands more dynamically. When they hurt, it’s not just about the pain, but also the functional limitations it causes.
Potential Causes of Thumb Pain
Joint Issues
Thumb pain can stem from joint issues. This can be due to wear and tear arthritis from overuse over many years, or inflammation from conditions like rheumatoid arthritis, gout, or other types of inflammatory arthritis. Generally, if your pain is worse with activity, it’s likely wear and tear arthritis. If it’s worse with rest, it’s likely inflammatory arthritis.
Tendon Problems
Several tendons around the thumb provide motion, range of motion, and power. Pain location can indicate which tendon is damaged. Pain on the backside of the thumb when extending it may indicate De Quervain’s tenosynovitis. Pain on the other side causing triggering or catching of the thumb may indicate an irritation of the flexor tendon, known as trigger thumb or trigger finger.
Ligament Issues
Ligaments connect bones and provide support and stabilization. Overusing your thumbs, such as from texting or computer use, or an acute injury from sports or work, can overstretch the ligaments, leading to joint instability and pain. Chronic ligament instability can also lead to arthritis.
Nerve Problems
Nerves supply sensation to the thumb and can get compressed or irritated, causing pain. For example, compression of the median nerve at the wrist can cause carpal tunnel syndrome, leading to pain in the thumb. Compression of the radial nerve can cause pain and tingling in the back of the thumb. Irritation of the C6 nerve root in the neck can also cause thumb pain.
Diagnosing Thumb Pain
As a physician, several key factors are considered to diagnose thumb pain:
Symptoms
What are your symptoms? Pain with specific activity, triggering in the thumb, numbness and tingling, or swelling can help direct the diagnosis towards joint, tendon, ligament, or nerve-related pain.
Examination
Tenderness during examination can indicate the source of pain. Joint tenderness, tendon tenderness, nerve compression, or swelling in the joint are important clues.
Imaging
Imaging can also be helpful. X-rays can show arthritis, while ultrasound can detect inflammation, joint instability, or soft tissue injuries. MRI is rarely needed but can be used for more subtle injuries. EMG or nerve conduction studies can diagnose pinched nerves at the wrist, elbow, or neck.
Conclusion
Based on symptoms, examination, and imaging, the cause of thumb pain can be determined. Treatment depends on the specific problem causing the pain. For more information on treating these issues, check out our other content.
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