Introduction
In the ball of the thumb there are some short thumb ball muscles, which cannot produce much force, but are necessary for many movements to move the thumb at all. In addition to these muscles, the ball of the thumb also contains the important thumb saddle joint, which is essential for the many movements of the thumb. If arthrosis develops in the thumb saddle joint during the course of life, this can also lead to pain in the ball of the thumb.
The causes
The causes of pain in the ball of the thumb are very diverse and usually harmless. Diseases of the tendons, muscles, nerves or bones are responsible for pain in the ball of the thumb. In many cases, incorrect strain or overstrain is the cause.
Furthermore, injuries, accidents as well as autoimmune diseases associated with joint inflammation, such as rheumatism, can damage muscles, tendons, nerves or bones. As different as the causes of pain in the ball of the thumb are, so different are the accompanying symptoms, which can give an indication of the underlying disease. After a fall, in which the affected person uses his or her hand to restrain himself or herself with the thumb out, a sudden overstretching of the ligaments can occur, which can even lead to a torn ligament.
In addition, a bony tearing of the ligament can occur. This injury process is also known as the ski thumb, since the collateral ligament of the thumb is often injured during skiing. The thumb joint usually swells strongly, gripping movements are almost impossible and the movement of the thumb is very painful.
If there is a swelling of the ball of the thumb after a fall, a doctor should be consulted to identify and treat serious injuries or those requiring treatment. You can find more information about the ski thumb here. A so-called rhizarthrosis is a degenerative joint degeneration in the thumb saddle joint, which is located in the ball of the thumb.
This joint allows many movements such as the rotation of the entire thumb and the opposition of the thumb to the other fingers, which is called opposition. Rhizarthrosis is relatively common, especially in women. Ten percent of women over 50 are affected, while men are less likely to be affected.
Often the rhizarthrosis occurs simultaneously on the opposite side or other finger joints are also affected by osteoarthritis. Since the arthrosis of the thumb saddle joint progresses gradually, this is also reflected in the symptoms. In most cases, load-dependent pain occurs in the area of the lower thumb saddle joint and in the area of the extensor side of the thumb saddle joint.
If the disease progresses further, the pain becomes stronger and the strength of the joint decreases. This often manifests itself in everyday activities that are difficult to perform with pain, such as opening a bottle or screw glasses. Many patients also suddenly drop objects from their hands.
Pain in the ball of the thumb also occurs at rest and at night. Likewise, the spreading of the thumb and rotations are only possible to a limited extent. If the arthrosis continues to progress, it can even become completely impossible to spread the thumb due to bony changes, which leads to hyperextension of the metacarpophalangeal joint.
If the physician examines the ball of the thumb, he or she may provoke a distinct painful pressure over the thumb saddle joint in the case of rhizarthrosis. Often the doctor can also detect painful crepitations (audible and palpable crackling sounds) above the joint. In carpal tunnel syndrome, a permanent constriction of a nerve – the median nerve – occurs, which pulls over the forearm into the hand.
At the transition from the forearm to the hand, there is a ring-shaped retaining ligament that surrounds the finger tendons, among other things, but which constricts the nerve in carpal tunnel syndrome. Initially, pain appears in the index and middle finger and in the thumb. In the further course of the disease, the thumb ball musculature shrinks.
The reason for the syndrome is often overstrain. However, this disease can also occur without a recognizable cause or in the context of a joint inflammation. The therapy should be carried out early with immobilization and pain therapy.
Often the holding band that constricts the nerve has to be split surgically. Gout is a so-called affluence disease, as it occurs particularly in people who consume a lot of alcohol and meat.When there are high uric acid levels in the blood (so-called hyperuricemia), the uric acid is deposited in the joints in the form of salt crystals and causes discomfort. Although the metatarsophalangeal joint of the big toe is often affected by gout, the inflammation can also occur in the metatarsophalangeal joint of the thumb.
An acute attack of gout leads to joint inflammation and pain in the ball of the thumb, even at rest. In addition, swelling and redness of the ball of the thumb can occur. Painkillers, so-called NSAIDs (non-steroidal anti-inflammatory drugs), are administered to relieve the pain and inflammation.
In order to prevent a renewed attack of gout, the drug Allopurinol is prescribed for constant intake and to lower the uric acid in the blood. The rapid thumb is also known as tendovaginitis stenosans, where an inflammation causes a knotty thickening of the flexor tendon with temporary entrapment. The tendons of the thumb and also the other fingers are connected to the bone by the so-called ring ligaments.
When bending and stretching the thumb, the tendon slides in the ring ligament. The term “fast thumb” comes from the fact that the thumb’s thickened flexor tendon makes it difficult to overcome the ring band when sliding. Once the resistance is overcome, the thumb snaps or snaps into the desired position.
The bending and stretching is very painful in the course of the procedure. A possible therapy is a splitting of the ring ligament. You can read more about this topic here: The quick thumb.
With the ski thumb, a rupture of the collateral ligament occurs after a fall with the thumb stretched out. This causes a pressure pain over the ball of the thumb as well as instability. If the ligament is only partially torn, the thumb is immobilized and painkillers are administered. However, if the ligament is completely torn, an operation must be performed to fix the collateral ligament again.