YOUR THUMB PAIN - WHYS AND WHEREFORES

Where to look for cause of thumb pain



Thumb pain + first CMC joint OA apparent cause of thumb pain.

Your painful thumb joint may even be swollen and an X-ray may show osteoarthritis, as this is a common site for it.

The pain is likely to be attributed to this thumb arthritis.

Case closed? Not likely!

Your forearm extensor muscles may be a source of thumb pain

Press into the forearm muscles below the elbow, and you may find the source of the pain.

The tenderness can be quite localized, just one little spot.

Squash the spot with your thumb for a couple of minutes, until you feel the muscle soften or you feel the tenderness lessen.

You may have to reposition your thumb if you feel it slip off the spot. The tenderness may not lessen until you let go.

Re-check your thumb. Hey presto, it’s less sore!

Here is another stretch for the forearm “extensor” muscles. Bend your wrist and pull the elbow straight. Hold this position until discomfort eases in perhaps two minutes.

stretching forearm extensor muscles



Having dealt with these tight muscles, have you finished?

There’s still more to come!

The job is probably less than half done, even if you do feel better already.

There are likely to be a number of muscles with tender areas, needing stretching.

Other muscles likely to be involved in your thumb complaint

The next is underneath the biceps muscle on the front of the upper arm, popularized by Popeye the sailor man.

With your arm down by your side and the palm facing forwards, the Brachialis muscle is on the front of the bone of the upper arm, above the elbow.

Pushing biceps aside and pressing backwards against the arm bone, you will be pushing on Brachialis, even though you won’t feel it as a distinct structure.

Poke at this muscle systematically up and down on each side of biceps, noting the most tender spots.



The next area to check is on the shoulder blade.

You can probably just reach this with your other hand, behind the armpit.

The front edge of the shoulder blade can be felt as a hard vertical ridge.

The Teres major and minor muscles overlying this edge, may be tender.

The Infraspinatus muscle behind this on your shoulder blade, is very likely to be tender, but you probably can’t feel all of it.

You could test it for tenderness by pressing up against a hard knob on something, or get someone else to press systematically all over it.

It derives the name Infraspinatus from its position below the Spine of the Scapula – the hard ridge you can feel at the back, if you put your other hand over your shoulder.

Any tender spots you have found, can be treated by pressure, and Infraspinatus can also be stretched by yourself. See also on shoulder pages of this website.

Place the affected hand over the opposite shoulder, with your elbow just under your chin (with you looking up.)

Now walk your fingers further, down the back. Use your other hand to push the elbow closer to the other shoulder.

If you can produce some discomfort or pain, hold the position until this goes.

Finding all these muscles sore pretty well guarantees that you will have a joint or joints "out" in your cervical and/or thoracic spine.

I would advise you to have a professional check on this score.



SCAPHOID FRACTURE

Another cause of pain at the base of your thumb is a broken scaphoid bone.

If you fall on your outstretched hand and end up with decently severe pain and tenderness here, get an X-ray.

This fracture can easily become less painful after a few days, and you may think it was just a sprain.

A missed scaphoid fracture will cause arthritis later - not good, more thumb pain.

If the initial X-ray is normal but your doctor is still concerned, further testing is very sensible. The narrow crack through the little bone may not show if the X-rays are angled even slightly off the fracture line.

A repeat X-ray after two weeks in an appropriate plaster cast, has been the accepted thing. The fracture line is now a little wider due to absorption of dead bone along the fracture.

A nuclear medicine bone scan will show a fracture within a few days.



DEQUERVAIN'S TENOSYNOVITIS

Is your pain just above your wrist in line with your thumb?

Do you have some tender swelling there?

This is likely to be Dequervain's tenosynovitis - inflammation around tendons due to overuse.

Ease up on whatever you have been doing to cause it. Try applying aloe vera gel, under plastic occlusion.

Plastic cling wrapping applied over any skin medication, dramatically increases its absorption into or through the skin.If you use a topical NSAID drug, the product information tells you not to use plastic occlusion. There will be a good reason for this advice.

If your thumb pain is bad enough, a cortisone injection will rapidly put paid to this condition.

Is this on the side you wear a wrist watch? If it is and you have a metal watch band, is there a slight groove around your arm where the watch band sits?
Replacing the metal band with a leather one, may fix your thumb pain.

Moving up your arm to the elbow.

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