Thumb pain

Pain in the thumb could be of different kinds: throbbing, prickling, tingling or sharp, shooting sensations can be felt. Apart from pain, there are other signs that can be seen on the thumb which may indicate the underlying disease.

Other signs can be:

• Stiffness
• Swelling
• Bruising
• Discolouration of the thumb (dark yellow or blue)
• Clicking sound on moving the thumb
• Nodules at the joint of the thumb

Thumb pain can be an indication of the onset of chronic disease. The causes of thumb pain can be:

• Excessive use: Continuous typing on the keyboard, painting, writing, and even playing video games can lead to pain in the thumb.
• Sprain: Sprained thumbs are common in people like skiiers and athletes who often indulge in sports that involve catching or throwing a ball like in cricket, volleyball, and basketball.
• De Quervain's tenosynovitis: In the case of de Quervain’s tenosynovitis, there are two tendons (structures that attach muscle to bone) present in the wrist and lower thumb which glide through a small tunnel-like sheath and connect to the base of the thumb. Repeated motions of hands like gripping, grasping, clenching or pinching irritates the sheath. This irritation leads to swelling and pain at the base of the thumb, thus restricting movement.
• Gout: Gout is a painful condition where the joints of the body can appear red, swollen and extremely painful to even move. Initial signs of gout can be seen at the small joints of the thumb. 
• Arthritis: Thumb arthritis occurs when the cartilage at the carpometacarpal joint (joint at the base of the thumb) wears away. It is commonly seen in old aged people. It can present as swelling, stiffness, tenderness and inability to use the thumb for basic chores like opening the lid of a jar.
• Carpal tunnel syndrome: Due to overuse of the wrist, especially while working on the computer, there is a tingling sensation, pain and numbness in the hand and wrist. Carpal tunnel is a narrow passage formed by the bones of the wrist. Carpal tunnel syndrome occurs when the tunnel swells up or is narrowed, putting pressure on the median nerve. 
• Stenosing tenosynovitis: Commonly known as trigger thumb, is a condition where the person feels pain, stiffness, and a locking sensation while bending and straightening the thumb. It occurs because of inflammation in the band of tissues called pulley, which holds the tendons used for flexion close to the finger bones. (Also read: Finger injury)
• Broken thumb: Change in colour of the thumb along with swelling could be a sign of a broken or fractured thumb.

There are basic changes that you need to make in order to avoid having thumb pain.

Try and avoid activities that elevate pain. If you cannot avoid the activity completely, give your hands a break after every 20 minutes of working.

Do regular hand exercises to keep the joints mobile. Exercises like thumb flexion, thumb extension and thumb touch can help in increasing the range of motion of the thumb.

• Thumb flexion: While you face the palm, extend your thumb towards the little finger as far as you can. Hold in that position for 30-60 seconds and then release. Repeat this at least four times with each thumb.
• Thumb extension: Put your hand on a flat surface and wrap a rubber band around the hand. The rubber band should be at the base of all the fingers. Now flex your thumb away from the fingers as far as you can. Hold in that position for 30-60 seconds and then release. Repeat this at least four times with each thumb.
• Thumb touch: With your hand stretched in front of you, touch the thumb with each fingertip and make an ‘O’. Hold in that position with each finger for 30-60 seconds and then release. Repeat this at least four times with each thumb.

Diagnosis of the underlying cause for thumb pain includes:

• Clinical examination: Swelling, redness, stiffness and other signs in the thumb can indicate many diseases.
• X-rays: Diseases like arthritis, gout, trigger thumb and de Quervain's tenosynovitis require X-rays for confirmation. A broken thumb would also require an X-ray to know the exact location and severity of the fracture.
• MRI scans and ultrasound: Sometimes to know the severity of the disease, doctors may prescribe an ultrasound or MRI scan.

The treatment for thumb pain depends on the cause of the pain:

• If the thumb is hurting due to excessive use or due to a sprain, then exercises, rest and cold compresses can help relieve the pain. 
• You may do RICE therapy, a combination of rest, ice, compression (wear a compression bandage to decrease swelling) and elevation by resting the affected thumb on an elevated spot.
• Treatment for de Quervain's tenosynovitis involves immobilizing the thumb and wrist with the help of a splint, applying ice packs and medications like ibuprofen to reduce pain.
• Gout and arthritis do not have any specific treatment. The aim in such cases is to relieve the pain with the help of painkillers and restore the function with the help of cold compresses and physiotherapy.
• Splinting the affected area, exercises and steroid injections help in relieving the symptoms of carpal tunnel syndrome. In severe cases, surgeries are performed to extend the tunnel and release the pressure on the median nerve.
• Rest, splinting, painkillers and steroid injections help in non-surgically dealing with a trigger thumb. In severe cases, tenolysis, that is, trigger finger release surgery is done.
• A cast is placed on the thumb to treat a fractured thumb.