Symptoms

Thumb pain: causes, diseases and treatment


Pain on the thumb

Thumb pain can be a significant impairment in everyday life because the thumb has a special function when gripping. Its special position is also reflected in the special mobility of the thumb and the enlarged area of ​​the brain compared to other fingers, which is responsible for the coordination and sensor technology of the thumb.

Definition

Thumb pain generally describes all painful symptoms in the area between the thumb saddle joint and the tip of the thumb. However, this article focuses on thumb pain that results from injury and diseases of the bones, tendons, muscles, ligaments, or joints. Superficial injuries such as burns or cuts are not considered here.

Thumb pain: symptoms

Thumb pain can manifest itself as, for example, punctual pain in the joint, painful swelling with significant pressure pain or pulling pain, which may extend to the forearm. In addition, the thumb's ability to move is often restricted and those affected have problems accessing it. For example, bottles and glasses are difficult to hold and a screw cap also presents considerable difficulties.

Depending on the cause of the complaint, accompanying symptoms can include, for example, increased falling asleep in the hands, forearm pain, neck tension or back pain.

Diseases as the cause of thumb pain

The possible causes of the pain on the thumb range from fractures and torn ligaments to acute inflammation and nervous disorders to chronic joint and bone diseases. Depending on the different triggers of the symptoms, the symptoms can also differ significantly.

Sprains, fractures and ligament tears

In the event of an accident or other increased force, the bones of the hands and fingers can be compressed or broken, which leads to painful swelling and restricted mobility. Fractures that cause thumb pain include, in addition to fractures in the direct area of ​​the thumb, so-called Bennett fractures, for example. This fracture at the base of the first metacarpal bone usually causes a pulling pain into the thumb saddle joint.

In the event of a broken scaphoid bone, access is usually also associated with considerable pain and the mobility of the thumb is significantly restricted. Most of those affected have difficulty bringing their index fingers and thumbs together. Given the pain, even some simple movements fail.

A rupture of the side band on the thumb (ski thumb) can cause swelling and massive pain in the area of ​​the thumb. This ligament tear usually occurs when the hand falls. The thumb spreads too much due to the load and the sideband travels. Occasionally, the rupture is accompanied by the splintering of a small bone fragment.

Pain in the thumb due to joint diseases

Various diseases can lead to joint pain in the area of ​​the thumb. Arthrosis should be mentioned first. If the joint wear affects the thumb saddle joint, this is known as rhizarthrosis. With certain movements, those affected experience deep thumb pain in the area of ​​the joint.

Acute joint inflammation, such as reactive arthritis or chronic polyarthritis, causes similar pain. The reactive arthritis usually goes back to an already survived bacterial infectious disease of the intestinal or urinary tract. Reactive arthritis, also known as Reiter's disease or Reitersche's disease, follows after the actual infection.

In addition to the pain in the thumb, further complaints such as conjunctivitis and / or urethritis are observed in such cases. The affected joints appear - as with the other forms of arthritis - red, warm and swollen.

Chronic polyarthritis (also rheumatoid arthritis) is one of the most common inflammatory joint diseases. In the course of the disease, chronic joint inflammation leads to irreversible destruction of the joint. The basic finger joints and carpal bones appear clearly shifted and the joints hurt massively.

Arthritis can also generally be triggered by bacteria and fungi that get into the joint through open wounds or the bloodstream. In the worst case, bacterial or mycogenic joint inflammation threatens blood poisoning, which is why therapeutic countermeasures are urgently required here.

Gout is actually a metabolic disease and not an immediate joint disease. However, since uric acid crystals are increasingly deposited in the joints in the course of gout, their function is significantly impaired and painful when moving. The remaining damage to the organism as a result of gout is usually relatively painless, so that the joint pain is the main symptom of the disease.

Gout can appear as an acute attack or become chronic. Sudden, unexplained joint pain accompanied by redness and swelling of the joints are a possible sign of an acute attack of gout. Fever can occur as an accompanying symptom.

Thumb pain caused by tendonitis

Special forms of tendonitis can also trigger the symptoms. Quervain's disease (tendovaginitis de Quervain) describes an irritation of the tendons of the thumb muscles (abductor pollicis longus muscle and extensor pollicis brevis muscle). An overload caused by frequent movement is usually the cause of the thumb pain.

The condition-related disease tendovaginitis stenosans, in which the flexor muscles or tendons of the thumb are impaired in their function, can also be associated with pain in the thumb in rare cases.

Legs over and other causes of thumb pain

If a leg is formed in the area of ​​the thumb, this can press on the surrounding ligaments, muscles and nerves and thus cause pain in the thumb.

In rare cases, repetitive strain injection syndrome (so-called mouse arm) also causes a painful tingling sensation in the thumb area. The constant repetition of certain movements leads to complaints that can range from the fingers to the shoulder, neck and back area. If the supplying nerves of the thumb muscles are pinched, for example in the course of a carpal tunnel syndrome, this can also cause sensory disturbances in the area of ​​the thumb, which can sometimes be perceived painfully.

Another possible cause is aseptic bone necrosis of Preiser disease, in which the scaphoid is slowly destroyed. In rare cases, the thumb pain is due to an enchondroma (benign tumor from cartilage tissue).

Diagnosis

The description of the symptoms can usually be used to draw conclusions about the possible causes of the thumb complaints. Sprains, fractures and ligament tears can be suspected due to the large swelling in the thumb and hand area, but the findings must be checked using imaging methods (ultrasound or X-rays) to narrow the diagnosis.

The imaging examination methods are also used to investigate suspected joint disease, whereby magnetic resonance imaging and computer tomography also play an important role. Peiser's disease and possibly existing ganglions or enchodromes are also visible with the imaging diagnostic methods. If in doubt, tendonitis can be clearly identified with the help of sonography (ultrasound).

A laboratory test of blood samples can provide further important information for the diagnosis. For example, a blood test for gout can show an increased uric acid level in the blood, and for arthritis, significantly increased inflammation levels in the blood can be seen.

Treatment of pain in the thumb

If the finger pain is due to a sprain, fracture or torn ligament, immobilization with plaster or an orthosis or splint is particularly necessary. Broken bones may need to be straightened beforehand so that they can grow back together appropriately. Once the acute injury has healed, physiotherapy is recommended for complete rehabilitation. In the event of a rupture, however, the ligaments may not grow back together properly, so that in case of doubt an operation is necessary to remedy a lateral ligament rupture on the thumb.

Similar to tendonitis, Rhizarthrosis is usually initially immobilized to allow the inflammatory processes to subside. Cooling envelopes as well as pain relieving and anti-inflammatory drugs are also said to help with the relief. If the rhizarthrosis does not go away in the course of conventional treatment, there is the possibility of an operation, for example the joint can be straightened or replaced by the implantation of a joint prosthesis.

With arthritis as a result of a bacterial infection, surgery is also required to remove the affected tissue to prevent blood poisoning. Chronic polyarthritis is usually treated with medication using pain relievers, anti-inflammatory drugs and anti-inflammatory drugs. If the damage to the joints progresses too far, an operation with correction or replacement of the joint is also possible here.

An acute gout attack is usually treated with anti-inflammatory preparations such as cortisol or NSAIDs. In order to avoid worsening of the symptoms and the development of chronic gout, many therapists advise to change the diet to a low-purine diet. Medicines can also be used to inhibit uric acid production (uricostatics).

Naturopathy for thumb pain

In the area of ​​manual therapy, osteopathy and Rolfing are the most important alternative treatment methods for thumb pain. These procedures not only look at the thumb and the surrounding tissue, but, according to their holistic approach, also address other complaints that could be related to the pain. These include, for example, neck tension, back pain or shoulder problems. Massages and acupuncture can relieve thumb pain, particularly in the case of underlying muscle and ligament complaints.

For joint diseases such as arthrosis or arthritis, different naturopathic treatment approaches are available, which in addition to manual therapies also include herbal treatments based on extracts or mother tinctures from devil's claw, nettles and willow. In addition, any acidity in the body that may be present should be remedied or the acid-base balance balanced.

Fasting as an extremely effective method for relieving the symptoms of rheumatoid polyarthritis. Schüssler salts and homeopathic remedies can be used in addition to reduce inflammatory processes in the body. (fp, nr)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dipl. Geogr. Fabian Peters, Barbara Schindewolf-Lensch

Swell:

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  • David R. Steinberg: Osteoarthritis of the Hand, MSD Manual, (accessed 06.09.2019), MSD
  • Bernhard Hirt, Harun Seyhan, Michael Wagner, Rainer Zumhasch: Anatomy and Biomechanics of the Hand, Thieme Verlag, 3rd edition, 2014
  • Assmus H. et al .: Diagnostics and Therapy of Carpal Tunnel Syndrome, S3 - Guideline, German Society for Hand Surgery, (accessed September 6, 2019), AWMF


Video: Mayo Clinic Minute: Is your thumb pain de Quervains tenosynovitis? (July 2021).