It’s estimated 40% of us will experience hand pain in our lifetime, thumb pain is the biggest reason. Our past post discussed the causes, now let’s look at what we can do about it.
Risk factors
- Gender-Women have a much higher incidence than men. Again, I can’t help but wonder if this is due to the way we throw on our shoulder purses, allowing its full weight to drop on the thumb at the last moment or from picking up little ones more with our thumbs than our entire hand.
- Age- There’s no question the older we are, the more at risk our thumbs become due to wear and tear, or lifting habits and the tools we use to survive each day e.g. our devices, kitchen utensils, tools.
- Obesity- We already know that weight bearing joints are significantly affected by weight. Every extra pound exerts four pounds of pressure on the knees. So a person 10 pounds overweight feels an extra 40 pounds of weight in their knees. But in the hand, it’s likely due to the adipose (fat) tissue itself, which is inflammatory because of the cytokinesis it produces which then leads to joint damage and pain.
- Heredity- hereditary conditions such as laxity in the joint/ ligaments, deformities that prevent normal use.
- Underlying issues- Other issues damage the structure and function of the thumb. Osteoarthritisis is the biggest culprit largely due to how we use our thumbs, but autoimmune diseases such as rheumatoid and psoriatic arthritis attack it as well.
- Repetitive stress activities- What we do at home or work that puts continual stress on the thumb.
- Trauma or injury- Some examples are old fractures or sprains and strains.
- Other l health conditions- Pregnancy, diabetes, gout, thyroid imbalances can increase the risk of impact at the thumbs.
Unhealthy uses
Too often thumb pain is caused or exacerbated by unhealthy thumb movements. For many, these include:
- Gloves that are too tight and restrict movement. It used to be a problem usually seen in the winter, but with COVID and increased glove use this has become rampant for us all. Gloves, when used properly, can actually help those who lift weights. We tend to hold a weight or bar bell too tightly when lifting, exerting extreme pressure on all the fingers. Gloves can add a slight wedge, keeping the fingers less stressed.
- Devices. Computer keyboards aren’t a big issue because we don’t type with our thumbs on those, but phones, tabled, and game controls are. It wasn’t until after I started writing my posts over three years ago that both thumbs began to trigger. This is likely due to how I hold my iPad when I input data.
- Lifting items such as our little ones, bottles, grocery bags, with our thumbs. The thumb is meant to guide, not lift. Over decades this can significantly damage the joint.
- Lifting or carrying purses, and briefcases that ultimately reside on the shoulder. All the weight of those we throw onto our shoulders fall directly onto our thumbs at the last moment. The answer? Place them onto the shoulder with the other hand.
- Opening jars. Too often we use our thumbs as the fulcrum to open them. Next time, try a device that allows you to grip and open with the entire hand.
- Many items in the kitchen, bath, bedroom, office or tools require thumbs to actively participate in getting the job done, such as hand held can openers or how we dry and fashion hair. But even playing an instrument, pulling on our clothes, holding a toothbrush and or how we use a pen when writing can be problematic. Often just tweaking our technique or turning to electric devices is enough to help.
Diagnosis
A thorough history and exam is necessary to define the specific cause. Lab tests may prove helpful to rule out underlying issues such as an autoimmune disease, diabetes, thyroid issues. X-rays can’t delineate soft tissue issues such as cysts, sprains, strains, but they can show swelling and bony, arthritic changes. But just because an X-ray shows significant damage in a joint doesn’t mean that will translate into symptoms. Many times a horribly arthritic joint is pain free. Tests performed on routine examinations such as a tinsel’s, phalen’s, Finkelstein, adson’s or an EMG/ NCV study, ultrasound or MRI can help delineate between the different types of causes for thumb pain
Symptoms
Trouble grasping, pinching, gripping with the affected thumb. Swelling, stiffness, pain, loss of motion, deformities, masses, nodules.
Treatment
It depends on what’s causing the pain and its severity. When acute or mild remember RICE:
- Rest the thumb for 48 hours
- Ice it immediately after injury or with an acute complaint. Use cold packs (see post on how to make your own) 20 minutes at one time several times throughout the day. Wrap it in a towel to prevent burning the skin.
- Compress. Wear an elastic bandage, over the counter splint, or ace wrap to reduce swelling and add stability and protection to the joint.
- Elevate your thumb to decrease swelling. Make sure it’s above your heart for the most benefit.
If not contraindicated, try a few days of over the counter non steroidal anti-inflammatiories (NSAIDs).
Change the way you perform activities that improperly stress the thumb.
Exercises
Make a fist- touch the thumb to the base of the 5th finger, repetitively touch the thumb to the tips of all the fingers. Make an “OK” sign with your thumb and other fingers. When the symptoms persist, see your provider. They may offer: steroids, injections, topicals ointments, creams, gels (see posts), physical therapy, or when appropriate, surgical options.
Thumb pain can be caused by a variety of concerns. From repetitive motion activities, to trauma, to underlying diseases. Whatever the reason- if rest, altering the offending behavior, or other home remedies do not alleviate the pain, get it evaluated to find the best treatment option for your situation.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4590160/ https://www.nhs.uk/conditions/hand-pain/thumb-pain/
https://www.healthline.com/health/thumb-pain#treatment
https://www.mayoclinic.org/diseases-conditions/thumb-arthritis/symptoms-causes/syc-20378339
https://www.yalemedicine.org/conditions/thumb-arthritis
https://onlinelibrary.wiley.com/doi/full/10.1002/art.40097
https://orthoinfo.aaos.org/en/diseases–conditions/arthritis-of-the-thumb/
https://orthoinfo.aaos.org/en/diseases–conditions/sprained-thumb