Thumb Joint Pain

Is thumb joint pain making your every day activity difficult? Could your pain be caused by thumb arthritis, basal joint arthritis, or possibly carpal tunnel syndrome? When you are experiencing thumb or hand joint pain, gripping can not only be painful but impossible. Learn about causes, treatments, and what can you do to regain your thumb function.



What Causes Thumb Pain?

The thumb joint is one of the most mobile joints in the body. Unfortunately with this mobility comes potential increased joint stress. With how much we use our thumbs in everyday activity, it’s no wonder why thumb joint pain is common. And, because use of our hands in every day life is so essential, thumb pain can be especially debilitating.

The joint of the thumb that receives excessive stress is the carpometacarpal joint or CMC joint. This joint is also referred to as the basal joint. The joint is formed by the metacarpal bone of the thumb articulating with the trapezium bone of the wrist. Like any joint, the surfaces of each bone are covered by articular cartilage. In addition, the ligaments and tendons surrounding the joint can all be potential sources of thumb joint pain.


Thumb Joint Pain


Trauma or injury to the thumb such as a sprain or fracture can lead to pain and limited function. A ‘jammed’ thumb refers to a sprain of the ligaments surrounding the joint. In extreme cases, disruption of these ligaments can lead to instability of the joint.

Overuse of the thumb is another source of thumb pain. Excessive wear of the thumb joint over time can lead to a break down of the joint cartilage causing inflammation and potential osteoarthritis of this joint. Excessive activity can also lead to inflammation of the tendons surrounding the thumb joint. Rheumatoid arthritis can also be a cause of thumb pain. If the tendons around the thumb become inflamed, tendonitis may occur leading to pain around the thumb joint.

Another potential source of thumb joint pain is carpal tunnel syndrome. Symptoms associated with CTS includes thumb pain, numbness, or tingling. CTS occurs when the median nerve becomes compressed at the wrist between the carpal bones and the transverse ligament. In addition to pain, numbness, or tingling in the thumb and first finger, atrophy of the muscles at the base of the thumb (thenar eminence) can occur with CTS.




Symptoms of Thumb Joint pain

Pain is the greatest issue with injury, inflammation or arthritis of the CMC joint. Activities involving gripping are generally the most painful. Swelling, stiffness, or tenderness in the region may be present. In the early stages, pain occurs with use or activity.

However, if the inflammation progresses, pain will also occur at rest. Functional activities such as opening jars, doors, as well as dexterity activities such as buttoning buttons, and writing become painful and limited. In addition, if the condition worsens, both the range of motion and the strength of the joint can become limited.


Thumb Joint Treatment

Conservative treatment can be very effective in the treatment of thumb pain. Treatment begins by resting the joint by limiting the aggravating activities. If a trauma injuring a ligament occurred, healing can take 6 to 8 weeks. In cases in which any movement is painful, splinting of the thumb joint to help provide rest is beneficial.


thumb splint


Anti-inflammatory medications and creams can also be helpful in reducing local joint inflammation (consult your doctor regarding medications). Reducing inflammation by utilizing ice therapy therapy is also beneficial. Because the area is very superficial, simply massage an ice cube over the area for a few minutes. In cases in which oral or topical medications are ineffective, injections are often a treatment of choice.


Physical Therapy

Typical physical therapy treatment for thumb pain can include modalities, mobilizations, and exercise. If you do seek physical therapy care, search for one who is also a certified hand therapist (CHT). Therapists that are CHT certified have additional training in the treatment of hand injuries and surgeries.

Typical modalities used in physical therapy for the thumb can include ultrasound, ice therapy, and iontophoresis. Ultrasound works by helping to increase tissue temperature and promote healing. Another type of ultrasound called phonohoresis can also be used. This type of ultrasound utilizes a gel that has an anti-inflammatory medication mixed in it to help in reducing inflammation. Iontophoresis is another modality that utilizes anti-inflammatory medication but utilizes electrodes to help administer the medication.

For a thumb that has lost some of its mobility such as with thumb arthritis, joint mobilizations will be an important part of the treatment program. With joint mobilizations the therapist manually glides and slides the joint to help restore joint mechanics.

Exercises are also very important in restoring the mobility and function of the thumb following injury. Range of motion, dexterity, and strengthening exercises are generally part of a typical treatment protocol. It is very important that when performing any exercise for thumb joint pain that they be pain free as pain will increase inflammation and delay healing.

For specific exercises for both range of motion and strength click here:
thumb pain exercises.


thumb jont exercises


Finally, when conservative treatment for thumb pain is not successful, surgery may be warranted.


Summary

• Thumb joint pain most commonly involves the CMC (basal joint) and can be caused by trauma or overuse.

• Other potential sources of thumb joint pain can include rheumatoid arthritis, osteoarthritis, and carpal tunnel syndrome.

• Pain, swelling, limited range of motion, and limited function with gripping are common thumb joint pain symptoms.

• Common treatment includes ice therapy, anti-inflammatory medication, thumb splinting, and physical therapy.


Thumb joint pain does not have to mean a life time of limitation. Whether your pain is from thumb arthritis, tendonitis, or carpal tunnel, follow the treatment recommendations and reclaim your function.


References

Joint Bone Spine. 2012 Aug 4. [Epub ahead of print] Hand osteoarthritis: New insights. Gabay O, Gabay C.

Semin Arthritis Rheum. 2010 Jun;39(6):465-76. Epub 2009 May 31. Hand osteoarthritis: an epidemiological perspective. Kalichman L, Hernández-Molina G.

Plast Reconstr Surg. 2011 Feb;127(2):918-25. An evidence-based approach to treating thumb carpometacarpal joint arthritis. Haase SC, Chung KC.

J Rehabil Med. 2010 May;42(5):469-74. Assessment of the effectiveness of a functional splint for osteoarthritis of the trapeziometacarpal joint on the dominant hand: a randomized controlled study. Gomes Carreira AC, Jones A, Natour J.

Cochrane Database Syst Rev. 2009 Oct 7;(4):CD004631. Surgery for thumb (trapeziometacarpal joint) osteoarthritis. Wajon A, Carr E, Edmunds I, Ada L.



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