Human thumbs are opposable, which allows people to grip objects and perform fine motor movements.
Sometimes, a person may experience pain or a lack of movement in the thumb. These symptoms could indicate several underlying health conditions, ranging from systemic diseases, such as arthritis, to sprains and other injuries.
In this article, we discuss what causes thumb pain, how to treat it, and when to see a doctor.
There are numerous possible causes of thumb pain.
A thumb sprain is the stretching or damaging of the ligaments in the thumb. A ligament is a band of tough, fibrous tissue that connects bone to bone.
Someone with a thumb sprain will experience pain in and around the damaged joint.
When it occurs
According to the American Academy of Orthopaedic Surgeons, sprains most commonly occur when someone falls onto an outstretched hand.
Minor injuries where the ligament has not torn may heal with basic home care. Following the principles of RICE may help:
- Rest: Support the thumb and rest it for as long as possible.
- Ice: Apply an ice pack wrapped in a cloth for about 10 minutes every hour for the first day.
- Compress: Wear an elastic (ACE) bandage to reduce swelling.
- Elevate: Keep the hand raised above heart level to reduce swelling and pain.
If the thumb ligament has a partial tear, a person will need to wear a temporary cast to immobilize the thumb.
If the injury has caused a complete tear to the thumb ligament, a person will need surgery to repair it.
Broken or fractured thumb
In some cases, a bone within the thumb may break. These injuries cause intense pain that starts at the site of the damaged bone and can radiate through the wrist and forearm.
The bone from the tip of the thumb to the knuckle is known as the distal phalange. This connects to the proximal phalange, which extends to the base of the thumb. Within the hand, the proximal phalange connects to the first metacarpal, which extends to the base of the hand.
Depending on the type of thumb fracture and its location, the thumb may also become unstable. It may move loosely from side to side.
When it occurs
Bones in the thumb may break due to impact injuries or excessive stress. Common causes include:
- falling and landing onto the thumb
- bending the thumb too far back
- twist the thumb excessively
- blunt trauma to the thumb
If the bone fragments remain close to the break, a temporary cast may be enough to hold the fragments in place. A broken thumb may heal within 2–8 weeks. However, it may take longer after surgery or if the bone fragments have not shifted much from their normal positions.
During this time, a person may require regular X-rays to check that the bones remain properly aligned.
If the bone fragments have drifted far from the break, a person may require surgery to realign the fragments. A surgeon may use wire, pins, or screws to hold the fragments together while the bone heals.
A person may not regain full strength in their thumb for 3–4 months. During this time, they may need to perform exercises to help regain movement of the thumb.
Basal joint arthritis
Cartilage is a type of tissue that cushions and lubricates the joints. It allows bones within the joint to glide alongside each other without friction.
Basal joint arthritis (BJA) may cause the following symptoms at the base of the thumb joint:
- pain, stiffness, or swelling of the thumb joint
- red or tender skin near the thumb joint
- decreased range of motion in the thumb
- symptoms that worsen when moving the thumb
- severe pain when gripping or pinching
Some people also refer to this as thumb arthritis.
When it occurs
BJA occurs when the cartilage between the base of the thumb and the wrist wears away. This can happen for several reasons, including:
Arthritis is a progressive disease, meaning it will worsen over time. Treatments for arthritis aim to slow the progression of the disease and manage its symptoms.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are usually the first-line treatment for reducing BJA pain. Some additional measures that may help a person manage their arthritis include.
- recieving corticosteroid injections into the thumb joint
- undergoing surgery to fuse, reposition, or remove a joint that does not respond to the above treatments
- doing thumb exercises
- wearing a splint to stabilize the thumb joint
In trigger finger, inflammation of the tendon sheath causes the thumb or finger to catch or lock in a bent position. The condition may occur as a result of repetitive use or injury.
Some symptoms of trigger finger affecting the thumb include:
- pain and stiffness at the base of the thumb
- a sore nodule near the base of the thumb
- difficulty straightening the thumb
- a clicking or popping sensation when bending or straightening the thumb
When it occurs
According to a review published in the Journal of the American Academy of Physician Assistants, stenosing flexor tenosynovitis, or trigger finger, is one of the most common causes of hand pain.
The exact reasons for a person developing trigger finger are not known. However, it is more common in people with diabetes and rheumatoid arthritis and may result from activities that include forceful gripping or pinching.
The treatment for trigger finger depends on the severity and duration of symptoms.
Sometimes, the condition improves without treatment. However, taking NSAIDs such as ibuprofen can help to alleviate pain and inflammation.
Some treatment options for severe or persistent trigger finger include:
- wearing a splint to prevent muscle contractions that may worsen tendon inflammation
- having corticosteroid injections into the tendon sheath of the affected thumb
- undergoing surgery to free up movement of the affected thumb
- hand and thumb exercises
- wearing a splint at night to prevent muscle contractions
De Quervain’s tenosynovitis
De Quervain’s tenosynovitis (DQT) is similar to trigger finger. However, DQT involves inflammation of the tendons, whereas trigger finger involves inflammation of the tendon sheath.
DQT causes pain on the thumb side of the wrist. Other symptoms may include:
- pain or tenderness at the base of the thumb and the wrist
- swelling on the side of the wrist closest to the thumb
- pain that radiates through the forearm
- difficulty making a fist
- difficulty grasping objects
When it occurs
Experts do not know the exact cause of DQT. However, hobbies that involve repetitive motions or injury can lead to inflammation around the tendons of the wrist. This inflammation then restricts the movement of the tendons.
DQT is most common among women between 30–50 years of age.
The treatment options for DQT are the same as those for trigger finger.
Carpal tunnel syndrome
The carpal tunnel is a narrow tube of bones and ligaments inside the wrist. A large nerve called the median nerve runs through the carpal tunnel and into the palm. It provides sensation to the thumb, index, middle, and ring fingers.
When it occurs
CTS occurs when inflammation of the wrist compresses the median nerve. This can cause a burning or tingling sensation in the thumb and first three fingers. Other symptoms may include:
- decreased grip strength
- difficulty performing fine motor movements
- pain that radiates up the arm
Some potential causes of CTS include:
- repetitive hand motions
- wrist sprains or fractures
- rheumatoid arthritis
- cysts or tumors in the wrist
- diabetes or other metabolic disorders
- underactive thyroid gland
- overactive pituitary gland
People who experience mild or intermittent symptoms of CTS may benefit from the following treatments:
- resting the affected hand
- wearing a splint at night
- applying cool packs to reduce swelling and discomfort
- taking NSAIDs such as ibuprofen to reduce pain and swelling
- recieving corticosteroid injections to alleviate pressure on the median nerve
People who experience more severe symptoms of CTS may require surgery to sever the affected ligament. This will reduce pressure on the median nerve, thereby helping to alleviate pain. However, people who have this procedure may experience continued numbness or weakness in the hand.
Certain joints within the body contain synovial fluid, which helps to lubricate the joint.
A ganglion cyst that develops on or near the thumb can cause a visible lump under the skin. It may also cause pain and discomfort when moving the joint.
When it occurs
Direct injury to one of the joints in the thumb or activities that require constant use of the thumb are common causes of ganglion cysts.
Ganglion cysts sometimes disappear without treatment. Persistent ganglion cysts usually only require treatment if they cause pain or a loss of movement in the affected joint.
Some potential treatment options for a ganglion cyst include:
- wearing a brace to immobilize the wrist and help shrink the cyst
- draining the cyst using a needle and syringe
- having surgery to remove the cyst
Some general self-care tips for thumb pain include:
- avoiding repetitive hand activities
- wearing a splint or brace to immobilize the thumb
- applying an ice pack to reduce inflammation
- avoiding wearing jewelry or gloves that constrict the thumb
Exercises can help to strengthen muscles in the hand and improve mobility. Below is a selection of exercises that can be beneficial for the thumb specifically.
Thumb and finger squeeze
This exercise can help to strengthen the whole hand and forearm.
- hold a ball between the thumb and first finger
- squeeze for 5 seconds and release
- repeat up to 10 times
- perform three sets of these
- swap hands and repeat
Thumb and finger lift
Strengthening the individual digits of the hand can help to target problem areas, such as the thumb. For this exercise, all a person requires is a flat surface.
- place both hands flat on a surface
- raise both thumbs slowly while keeping all other fingers flat
- bring the thumb back down
- repeat this for each finger of the hand
- repeat as neccesary
Many thumb injuries can result from activities involving gripping. Specifically, working on the opposable motion of the thumb may help strengthen the muscles and joints in the digit.
- lay the back of the hand on a table, with the palm facing upwards and fingers spread out
- reach the thumb over to the base of the little finger
- hold and release back to the start position
- repeat up to 10 times
- repeat on the opposite hand
People should contact a doctor if their thumb pain is persistent, severe, or impacts their ability to perform daily tasks and activities.
People should seek immediate medical attention if they believe they may have dislocated or fractured their thumb. Some signs to look out for include:
- inability to move the thumb
- swelling or warmth in or around the thumb
- a thumb that appears crooked or feels unstable
To diagnose the underlying cause of thumb pain, a doctor will conduct a physical examination and ask about potential causes. If the cause of the pain is unclear, the doctor may order imaging tests, such as an X-ray, MRI, or ultrasound.
Thumb pain can occur as a result of repetitive movements, injury, and systemic inflammatory diseases.
Thumb pain itself does not present a significant health risk. However, it may be a sign of a more serious condition, such as a broken bone or arthritis.
People can treat thumb pain at home by resting the thumb, applying ice packs, and taking painkillers. People should seek medical care if their thumb pain is persistent, severe, or significantly interferes with their ability to perform daily activities.