Pain in the thumb – Is that dangerous?

Introduction

The thumb (Pollex) is the first finger of our hand and has a very special meaning for people because it is indispensable for grasping. Due to the high strain on the thumb, pain in the thumb is particularly severe; it can be very restrictive in everyday life.

What other symptoms can occur with thumb pain?

In addition to the pain in the thumb, there can be various accompanying symptoms:

  • SMS Thumb: At first there is a pulling in the thumb, which then leads more and more to pain and immobility of the thumb. A swelling or redness is not to be expected since the pain is caused by the inflammation of a tendon.
  • Rhizarthrosis (arthrosis of the saddle joint): Pain occurs under stress, especially gripping movements or opening a bottle lead to severe pain. After prolonged stress, swelling can occur in the area of the inflamed thumb joint.
  • Ganglion: ‘ In addition to the pain in the thumb there is a very large swelling in the thumb area.

    Movement pain or a numbness can occur.

  • Fracture: There is severe pain, swelling and bruising around the thumb. In rare cases, numbness may occur.

The skin and muscles of the hand are supplied by three major nerves. The radial nerve provides the sense of touch to the outside of the thumb and the adjacent back of the hand, while the median nerve is responsible for the inside of the thumb and the adjacent half of the palm.

For this reason it is important to know which area of the thumb is numb or painful. In most cases, the tip and inside of the thumb are affected, which indicates damage to the median nerve. A numbness is a subjective sensation that is perceived as extremely unpleasant by those affected.

This can occur in addition to pain in the thumb and hand area and can radiate into the forearm or even upper arm and shoulder. A numbness can be an indication of nerve damage and requires thorough medical diagnosis. Numbness in the hand area is often the result of carpal tunnel syndrome.

In this case the nerve is affected by a narrowing of its path through the carpal tunnel of the wrist. This usually occurs as a result of mechanical overloading or inflammation of the anatomical structures running through the carpal tunnel, which causes tissue swelling. The subsequent damage to the nerve typically results in pain, sensory disturbances or numbness and possibly weakness in certain muscle groups of the hand.

Pain in the thumb can be attributed to various causes.

  • Accidents and falls can lead to injuries to bony structures, tendons and ligaments.
  • A frequent cause is wear-related arthrosis in the area of the thumb saddle joint and/or the metacarpophalangeal joint.
  • Overuse of the thumb, in the context of an extraordinary smartphone use, can cause the image of a cell phone thumb or SMS thumb.
  • Other possible causes of thumb pain are gout,
  • A carpal tunnel syndrome that radiates into the thumb,
  • Tendinitis and
  • For example, a ganglion (upper leg).

However, it is interesting to note that everyday activities such as texting or writing whatsapp- writing put more and more strain on the thumb and therefore tend to cause painful inflammation. This phenomenon is often referred to as SMS thumb.

The pain in the thumb is caused by the fact that the movement with which one scrolls over the cell phone or with which one types a message is not natural for the thumb. The frequent stretching of the thumb overstrains the muscles in the thumb. Therefore, frequent use of the cell phone can lead to inflammation of the tendons.

The tendons usually belong to the extensor muscles of the thumb, such as the musculus extensor longus or musculus extensor brevis. However, this pain does not occur suddenly but announces itself slowly. It is therefore particularly important not to ignore the body’s first warning signals.

Usually there is an unpleasant pulling in the thumb at first, then slight pain in the thumb and later every grab becomes a torture because the eyesight is already inflamed by then. The cell phone thumb, also SMS thumb, is a clinical picture that is becoming more and more common.Excessive strain on the thumb muscles, especially on one side with the dominant hand, leads to overloading. In particular, the extensor muscles of the thumb are overstressed.

Frequent consequences are an inflammation of the tendons in the thumb and an acute joint inflammation in the thumb saddle or metacarpophalangeal joint. In the long term, degenerative changes such as arthrosis are favored. To prevent a cell phone thumb, it is recommended to relieve the thumb from time to time and to use several fingers when typing.

Tendovaginitis de Quervain, also simply called Quervain’s disease, is a special form of tendovaginitis (inflammation of the tendon sheath). This is an inflammation of the so-called first tendon compartment, through which the tendons of two muscles of the thumb originating on the forearm run. Repeated heavy strain, often during desk work, can lead to inflammatory changes in a tendon sheath.

Tendovaginitis in the area of the tendon sheaths of the thumb muscles is known as Tendovaginitis stenosans de Quervain. In most cases, the cause is overloading of the two tendons due to frequent abduction. Such an abduction is the spreading of a body part away from the center of the body, in this case the spreading of the thumb away from the palm.

However, a genetic predisposition also seems to play a role. A typical patient group are mothers who often use a strong thumb spread when holding the child. The disease can also occur when typing extremely frequently on a cell phone.

As with other forms of tendosynovitis, tendovaginitis de Quervain manifests itself through an intense stabbing or pulling pain over the tendon in the area of the wrist below the thumb or radiating into the forearm. These occur mainly when holding and grasping firmly, but also with movements of the thumb in general. Apart from this, the inflammation can make itself felt by a reddening and swelling of the affected area.

If the tendovaginitis is very pronounced, affected persons often describe a noticeable and audible rubbing. The treatment of Quervain’s disease is similar to that of other tendovaginitis. First and foremost, it is important to take an anti-inflammatory drug such as ibuprofen or diclofenac and to immobilize the tendon or muscle.

To alleviate the inflammation, the affected area should also be cooled and, if necessary, cortisone injected. If these measures still do not result in healing of the tendovaginitis, surgical splitting of the tendon sheath can be successful. Carpal tunnel syndrome is a complex of symptoms caused by an anatomical narrowing in the so-called carpal tunnel.

A nerve, the median nerve, runs through this anatomical channel. In the early stages of carpal tunnel syndrome, compression of the median nerve causes nocturnal pain in the thumb, index and middle finger as well as sensitivity disorders such as numbness and tingling. Massaging or shaking the hands typically relieves the symptoms quickly.

As the disease progresses, the strength of the thumb muscles decreases. This means that night-time pain in the thumb in particular can be an early sign of carpal tunnel syndrome. Arthrosis is a degenerative joint disease caused by wear and tear of the joint.

It is an incurable disease in which cartilaginous structures in joints perish. A widespread form of arthrosis is rhizarthrosis of the thumb saddle joint. In addition, osteoarthritis can occur in the metacarpophalangeal joint of the thumb and rarely in the end of the thumb.

In addition to pain in the joint, those affected suffer from an increasing restriction of movement and instability in the joint. Over time, they lose strength. Another cause of pain in the thumb can be a disease of the thumb saddle joint.

The thumb saddle joint is located at the transition from the carpal bones to the first finger. If arthrosis (rhizarthrosis) occurs in this joint, this is manifested by severe pain. The pain occurs mainly during movement, for example when trying to grasp an object with the thumb.

The cause of the joint wear and tear lies in the anatomy of the thumb saddle joint. The thumb is the most mobile of our fingers. Depending on the movement, however, the thumb joint is in an extremely unfavorable position.The two joint surfaces then no longer mesh properly and frictional movements occur, which grind or deform the joint surface.

This deformation then leads to the fact that both joint surfaces no longer mesh properly with each other. This leads to wear and tear and to pain in the thumb, which becomes increasingly severe, especially during movements. The metabolic disease gout is caused by an increased uric acid level in the blood.

The salt of uric acid is deposited in joints in the form of uric acid crystals and causes painful attacks of gout. An acute attack of gout is most frequently accompanied by severe pain, severe redness and swelling due to effusion and occasionally even systemic signs of inflammation such as fever and a general feeling of illness.

  • The metatarsophalangeal joint of the big toe,
  • But also ankle joint,
  • Tarsal,
  • Knee
  • As well as wrists and finger joints.
  • The metacarpophalangeal joint of the thumb is often affected by an acute attack of gout.

Another cause of pain in the thumb can be a so-called ganglion (also known as a ganglion).

A ganglion is a fluid-filled sac of a joint capsule or tendon sheath. The ganglions often occur close to the joint and often in the area of one of the thumb joints. This benign change can cause severe pain and significantly restrict joint mobility depending on its size and location.

A ganglion is usually visible from the outside and is highly elastic. The pain is caused by the narrowing of a nerve. If the nerve is completely constricted, a numbness in the thumb may even occur.

However, this is very rare. Like every bone in the body, the bones of the thumb can break in the event of a fall or direct impact on the thumb. The Bennett fracture is a bone fracture that runs from the base of the first metacarpal bone to the thumb saddle joint.

This is a fracture in the capsule of the thumb saddle joint, which then leads to a dislocation of the thumb. As a result, there is severe pain and swelling in the thumb area. The fracture is typically caused by an axial direct or indirect violent impact on the thumb resting on the hand, for example when falling on the hand.

The luxation fracture is always treated surgically. Winterstein’s fracture is a fracture outside the joint. It is an oblique fracture of the first metacarpal bone close to the base.

In the case of an irrelevant displacement of the fracture, conservative therapy with a plaster splint is possible. Displaced fractures are typically straightened surgically. Generally, fractures or torn ligaments in the thumb area always cause severe pain, usually accompanied by swelling or bruising. The mobility of the thumb is restricted or not possible at all.