There may be several reasons why your thumb hurts. But in any case, this is the result of pathological changes in tissues. Joints, muscles, ligaments, tendons, nerves, and blood vessels can be affected. In this article you can learn about the main reasons for the appearance of such a clinical symptom. The most common diseases are described. Information is given on how to choose the right doctor and where to seek medical help.
Most often, patients have pain in the thumb on their right hand - this is due to the fact that this limb is a “working” one. It requires the maximum amount of physical effort. Accordingly, some tissues that bear the load are destroyed more quickly.
In most cases, if the thumb on the left hand hurts, doctors suspect the development of carpal valve syndrome. This is most often an occupational disease. Develops during work associated with repeated repetition of the same type of brush actions. The carpal valve in the area of the wrist joint is destroyed.
To understand potential risk factors and the process of pathological changes, it is necessary to know at least the basics of anatomy and physiology. The human thumb consists of a metacarpal bone and two phalanges. They are all connected to each other using small joints. The metacarpal bone is attached to the base of the hand using the thumb joint.
Each joint has the same type of structure. These are two heads of bones covered with cartilaginous synovial tissue. It provides ease of gliding when making movements. The heads of the bones are placed in an articular capsule consisting of dense cartilage tissue. Inside the capsule there is also synovial fluid, which nourishes the cartilaginous membranes of the heads of the bones.
Ligaments are located near the joint - they stabilize the position of the heads of the bones and enable them to function correctly. Tendons are attached nearby, which pass into the fascia (sheaths) of the muscles that provide mobility to the thumb.
Innervation is carried out by a branch of the median nerve. It is formed by branches of the radicular nerves of the cervical spinal column. These branches then form the brachial nerve plexus. Three large nerves responsible for the innervation of the upper limb emerge from it. These are the median, ulnar and radial nerves.
The blood supply is carried out by small and medium-sized blood vessels. These structures can also cause pain. Further in the article we will consider in more detail all the possible reasons for the appearance of such a clinical symptom.
In the meantime, we would like to recommend that if you experience any pain in the joints, bones or soft tissues, you should immediately consult a doctor. Do not self-diagnose or treat. This may be dangerous to your health.
If on the eve of the onset of pain there was an injury (fall, bruise, dislocation, awkward movement, etc.), then immediately consult a traumatologist. This specialist will eliminate the possibility of a fracture or crack of bone tissue, sprain and rupture of ligaments, tendons, muscles, joint capsule, dislocation and subluxation.
If there was no injury, then you need to make an appointment with an orthopedist. This specialist will conduct an initial examination and make a preliminary diagnosis. If necessary, he may recommend additional consultation with a vertebrologist or neurologist (depending on the suspected cause of the symptom).
In Moscow, you can make an appointment right now for a free appointment with an orthopedist, neurologist or osteopath at our manual therapy clinic. To do this, just fill out the registration form located at the bottom of the page. Be sure to include your contact phone number. During business hours, the clinic administrator will contact you and agree on a time convenient for your visit to the doctor.
Why does the thumb on the left or right hand hurt?
The cause of pain is always the same - inflammation.
When it comes to joint problems, the culprit may not only be infection, but also tissue destruction. This can happen due to injury (bruise, fracture), nerve compression, salt deposits in the joints, when tiny crystals, like sandpaper, injure the delicate articular surface. The most common reason why the joint of the thumb on the hand hurts is arthrosis. This is inflammation of the joint, which is caused by salt deposits (for example, gout), old injuries, autoimmune diseases (for example, systemic lupus erythematosus), and degenerative connective tissue diseases. Some endocrinological diseases, as well as diseases associated with internal hemorrhages, such as hemophilia, can lead to arthrosis.
Depending on how exactly the diseased area of the hand behaves, the doctor draws a conclusion about what happened to the patient. The first question that will be asked is whether there were injuries. External influences can either lead to illness or provoke an exacerbation of an existing disease that had not previously manifested itself. So, there was no injury, but there was pain. There are the following reasons for this:
- when the thumb on the hand hurts when bent or at the base, arthrosis is most likely to blame; if it does not bend and hurts, then the disease has already gone quite far;
- if your thumb is swollen and painful, this may be a sign of Raynaud's syndrome;
- when the phalanx of the thumb on the hand hurts, both joints and ligaments and tendons may be to blame: their inflammation is manifested by sensations in the area of the phalanges;
- at night the fingers from the big to the middle go numb, the sensation can affect half of the ring finger - this is a sign of cubital syndrome, or more simply - pinching of the median nerve;
- if both arms hurt in the same places, you need to rule out autoimmune diseases.
If your feelings differ from the options proposed, describe them yourself. The time and conditions of pain onset, mobility in the joints, and the nature of the sensations (sharp, pulling, and so on) matter.
Pain in fingers
Pain in fingers. Causes of pain in fingers
Most often, pain in the fingers is caused by:
- polyosteoarthrosis of the fingers;
- rheumatoid arthritis;
- psoriatic arthritis;
- gout, or gouty arthritis;
- de Quervain's tenosynovitis;
- rhizarthrosis.
In addition, pain in the fingers (coupled with numbness) causes carpal tunnel syndrome and Raynaud's syndrome. Together, carpal tunnel syndrome and Raynaud's syndrome account for approximately 30-35% of cases of pain in the fingers.
Probably, having read the entire extensive list above, you are now thinking with horror that it will be very difficult to understand so many diseases and understand which of them is causing pain in your fingers. But actually it is not. It won't be too difficult to figure it out.
For example, two diseases immediately stand out from the general list - carpal tunnel syndrome and Raynaud's syndrome; they always occur with numbness of the hands. Therefore, if pain in your fingers is combined with numbness, read articles about carpal tunnel syndrome and Raynaud's syndrome.
If you have pain in your fingers, but there is no obvious numbness in your hands, you can safely exclude carpal tunnel syndrome and Raynaud's syndrome from the list under consideration. Other diseases of the fingers have such characteristic symptoms that it is most often not difficult to distinguish one disease from another. And below I will tell you about these characteristic symptoms. All you have to do is read carefully and compare your feelings with my descriptions.
Polyosteoarthrosis of the fingers, “knotty fingers”
Polyosteoarthrosis of the fingers accounts for approximately 40% of all cases of pain in the fingers. People at least 40-45 years old are affected (people under 40 years old suffer from this disease in extremely rare cases), but people aged 50-55 years and older are especially often affected by polyosteoarthrosis of the fingers. Women get sick much more often than men.
Polyosteoarthrosis of the fingers is characterized by the appearance of special nodules (the so-called Heberden's nodes) on the dorsal or lateral surface of those joints that are located closer to the nails. Heberden's nodes most often develop symmetrically, that is, on the right and left arms at the same time and in the same places. Moreover, they can form on any fingers, from big to little fingers.
During the formation of Heberden's nodes, burning and pain may occur in the joints underneath them; sometimes these joints become swollen and red. But in a third of patients, the formation of Heberden's nodes occurs asymptomatically, without pain or burning.
In addition to Heberden's nodes, with polyosteoarthrosis, low-painful nodules appear on those joints that are located approximately in the middle of the fingers (proximal interphalangeal joints). These are Bouchard's nodes. They have a spindle-shaped shape, develop very slowly and, with rare exceptions, almost do not hurt.
More details about polyosteoarthrosis >>
Rheumatoid arthritis
Rheumatoid arthritis accounts for approximately 5-7% of all cases of pain in the fingers. People of any age get sick, but most often those over thirty. Women get sick about 5 times more often than men. The disease usually develops after severe stress or after the flu, severe colds, infections or hypothermia.
Rheumatoid arthritis most often begins with inflammation and swelling of the metacarpophalangeal joints of the index and middle fingers (that is, with inflammation of the joints located at the base of these fingers, in the area of the protruding bones of a clenched fist). In most cases, inflammation of the metacarpophalangeal joints is combined with inflammation and swelling of the wrist joints.
Inflammation of the fingers and wrist joints in rheumatoid arthritis is symmetrical, that is, if the joints on the right hand are affected, then the same joints on the left hand are almost certainly affected. In most patients, the process often involves other joints of the fingers and toes, as well as large joints - knees, elbows, ankles, etc.
At the same time, the inflammatory rhythm of pain is most typical for rheumatoid arthritis: pain in the joints intensifies in the second half of the night, in the morning. During the day and evening the pain usually subsides somewhat.
Very often, the listed symptoms are accompanied in rheumatoid patients by a feeling of weakness, fever, weight loss and chills, i.e. the disease often leads to a general deterioration in the patient’s well-being.
Learn more about rheumatoid arthritis >>
Psoriatic arthritis
Psoriatic arthritis accounts for less than 5% of all cases of pain in the fingers. The disease most often affects people aged 20-50 years. In most cases (but not always), the disease develops in people who already have psoriatic skin manifestations - dry, scaly, reddish spots on the body or scalp (psoriatic plaques).
Damage to the fingers in psoriatic arthritis is characterized by the so-called “axial inflammation,” when all the joints of a finger swell at once. The finger itself turns red and looks like a sausage. This pathology is called a “sausage-shaped” finger.
With psoriatic arthritis, axial inflammation can occur in any finger. But note that with this disease, inflammation of the fingers on the right and left hands is most often asymmetrical, that is, as a rule, the fingers on one hand are affected; and sometimes on both hands at once, but then on one hand some fingers and joints become inflamed, and on the second hand - completely different ones.
Read more about psoriatic arthritis in Chapter 19.
Gout, or gouty arthritis
Gout, or gouty arthritis, accounts for less than 5% of all cases of pain in the fingers.
People commonly call gout a deformity of the big toe, which usually develops in women. But in fact, this is not gout, but arthrosis of the big toe. But “classic”, real gout (gouty arthritis) occurs more often in men. Women suffer from gout several times less often.
And while true gout often (but by no means always) begins in the long-suffering big toes, it can affect any joint in both the hands and feet.
Gouty arthritis usually appears between the ages of 20 and 50. The first to become inflamed, as already mentioned, are the joints of the toes or the knee or ankle joints. On the hands, the joints of the thumbs become inflamed most often (but any other fingers can become inflamed, either on one hand or on both).
Inflammation of the joints during gout occurs in the form of attacks. In most cases, a gout attack occurs completely unexpectedly: it usually begins against a background of complete health, most often at night. The pain in the joints during a gouty attack is often very acute: according to patients, “it makes you want to climb the wall.” During such an attack, the affected joint turns red, the skin over it becomes bright red or purplish and hot to the touch.
Although in some patients, especially women, the attacks are milder, without redness of the joint and without such acute pain. But in any case, an attack of gout occurs unexpectedly and lasts from 3 to 10 days; then he suddenly passes as if nothing happened. However, after some time, the attack just as suddenly recurs again.
This paroxysmal course of the disease is the hallmark of gouty arthritis.
More details about gout >>
De Quervain's tenosynovitis
De Quervain's tenosynovitis accounts for approximately 5% of all cases of pain in the fingers. This is an inflammation of the ligaments and “small” muscles in the area of the thumb exclusively. Other fingers do not become inflamed with de Quervain's tenosynovitis.
De Quervain's tenosynovitis can occur at any age in both men and women. Characteristic symptoms: pain at the base of the thumb and under it, where the thumb comes into contact with the wrist joint.
Pain can occur spontaneously, “out of the blue,” but most often it appears when putting pressure on the thumb, when trying to press the thumb on something, or when trying to grab something with the thumb and index finger. In addition, the pain intensifies when the thumb is extended towards itself, i.e. towards the elbow.
For more information about de Quervain's tenosynovitis, see Chapter 6.
Rhizarthrosis - arthrosis of the thumb
Rhysarthrosis - approximately 5% of all cases of pain in the fingers. Rhizarthrosis affects the joint located at the base of the thumb and connecting the metacarpal bone of the thumb to the radiojoint.
Usually rhizarthrosis is one of the manifestations of polyosteoarthrosis of the fingers, and then making a diagnosis is not difficult. But in approximately 20-30% of cases, rhizarthrosis occurs as an independent disease, usually in people who constantly heavily load or have once extremely overloaded their thumb. In this case, it can be quite difficult to distinguish rhizarthrosis from de Quervain’s tenosynovitis, since the symptoms of these diseases coincide by almost 90%.
In such a situation, we can be helped to distinguish rhizarthrosis from de Quervain's tenosynovitis by the deformation of the bones of the diseased joint, which is clearly noticeable upon examination and is clearly recorded on an x-ray (with de Quervain's tenosynovitis, only changes in the soft tissues above the joint can be detected on an x-ray - and even then extremely rarely).
For more information about rhizarthrosis, see the chapter on polyosteoarthrosis of the fingers.
You can also watch Dr. Evdokimenko’s video on the topic of hand diseases >>
Article by Dr. Evdokimenko© for the book “Pain and Numbness in the Hands”, published in 2004. Edited in 2011
All rights reserved.
How to make a diagnosis
They begin to find out why the thumb on the right or left hand hurts with an x-ray.
This method of examination shows the condition of bones and joints. If there are signs of a fracture or inflammation inside the joint capsule, we are talking about injury or arthrosis. If no pathology is detected on the x-ray, it is most likely a neurological disease - carpal tunnel syndrome or another disease.
Electroneuromyography is used to diagnose tunnel syndromes. It allows you to confirm the diagnosis and make sure that nerve compression occurs exactly where the doctor suggested. But an experienced neurologist or surgeon can establish this diagnosis only by symptoms: they do not occur in other diseases.
Blood tests are rarely taken, as a rule, when a systemic disease is suspected, the result of which is disease of small joints.
Diagnostic methods
The diagnosis is made based on the patient’s complaints, external examination, and medical history. The doctor conducts a series of functional tests to assess muscle strength, range of motion, and the intensity of symptoms. The following instrumental studies are prescribed:
- radiography to detect deformation of bone structures;
- MRI, CT, ultrasound, which help to detect the localization of inflammation, determine its severity and the degree of damage to cartilage tissue.
To make a diagnosis, the results of general clinical tests, biochemical and serological studies (level of rheumatoid factor, antinuclear antibodies, C-reactive protein) are required. Biological samples are sown into nutrient media to determine the type of infectious agents and their sensitivity to drugs.
How to relieve the condition
In the acute phase of the disease, the affected area is given rest and anti-inflammatory drugs are used to remove the cause of the disease, or as a pain reliever for injuries. As soon as the condition allows, they begin to move the arm, giving it moderate loads to improve blood circulation. Then, in order to relieve pain in the thumb of the left or right hand, they act on the causes of the disease: they treat inflammation in the place that caused the pain with the help of anti-inflammatory drugs, physiotherapy, and exercise therapy.
In case of injury, a traumatologist will help you recover, and in all other situations, a therapist. He will prescribe all the necessary examinations and determine whether he can solve the problem on his own, or whether the help of a neurologist, orthopedist or surgeon will be required.
In case of carpal tunnel syndrome, in addition to treatment, you will need to reconsider your usual postures and, possibly, purchase several devices that will help reduce the load on the hand.
Degree of damage
Mild discomfort in the thumb is a sign of developing inflammatory or degenerative pathology. Usually only infectious, reactive, rheumatoid, and gouty arthritis manifest acutely. Other pathologies develop gradually.
| The degree of damage to pathologies of the joint of the thumb | Clinical manifestations |
| 1 degree of severity | Painful sensations occur after intense physical exertion, hypothermia, and acute respiratory viral infections. They disappear after a short rest. There are no visible signs of joint damage |
| 2nd degree of severity | The pain intensifies, appears when bending and straightening the finger, and is accompanied by crunching and clicking sounds. There is slight swelling in the joint area |
| 3 degree of severity | Pain occurs with movement and at rest. She is twitching, strong, constant. The skin becomes red, swollen, and range of motion is significantly limited. |
Prevention is the crux of the matter
Prevention consists of preventing injuries, overloads and hypothermia of the hand. Regular exercise helps a lot: the better the blood circulation in the small joints, the less likely they are to get sick.
Unfortunately, it is impossible to prevent autoimmune diseases. But the earlier a doctor detects such a disease, the less destruction it manages to cause in the body: such diseases often affect not only the periphery of the body, but also vital organs. Therefore, it is important to pay attention to discomfort in small joints and promptly find out their cause.
How is rhizarthrosis treated?
As with other joints, treatment for osteoarthritis of the thumb depends on the stage at which the disease is detected. It is very important to make a correct diagnosis, because similar symptoms occur with gout, arthritis and other pathologies.
At an early stage, it is enough to take medications to improve metabolism and strengthen cartilage. Physiotherapy also helps well, especially if you go to a sanatorium-resort treatment for general health improvement.
If the symptoms intensify, a comprehensive regimen is prescribed:
- painkillers;
- short-course non-steroidal anti-inflammatory drugs;
- chondroprotectors – to activate the production of new cartilage cells;
- manual therapy sessions (proper adjustment of a deformed joint reduces pain);
- massage to increase the tone of cartilage tissue and improve joint mobility.
Manual therapy and massage are good in the initial stages of rhizarthrosis
To keep your hands healthy, perform simple gymnastics, for example, from the following exercises:
