Causes of Thumb Joint Pain and How to Find Relief

Treatments for CMC arthritis

If you have CMC arthritis, treatment can include:

Over-the-counter pain relievers

Huffstutter suggests starting with acetaminophen (Tylenol) or with gels containing the anti-inflammatory drug diclofenac (Voltaren) that you rub on sore joints. Long-term use of oral nonsteroidal anti-inflammatory drugs, like ibuprofen (Advil), has higher risks, he says.

Braces

Many people find that a “small, low-profile” brace can stabilize the thumb, prevent “bone-on-bone” motion and reduce pain, Barr says.

Corticosteroid injections

If more conservative measures aren’t enough, you may get some temporary relief with periodic injections from your doctor. “It’s not going to fix your arthritis,” Barr says, and the duration of relief varies greatly. “I’ve had patients they get one injection, it works for two years, and I’ve had some who get it … [and] a month later, it doesn’t work anymore.”

Surgery

The most common versions involve removal of the trapezium wrist bone, Barr says. The thumb is then stabilized with various techniques. While surgery works well for pain relief, it can require months of recovery, involving physical therapy and the use of immobilizing splints and braces, she notes. An alternative surgery, which involves fusing the joint at the base of the thumb, is used less commonly, Barr says, because it decreases the thumb’s range of motion. 

Occupational therapy

Occupational therapists can suggest gadgets and techniques to help you cope with thumb arthritis, Huffstutter says.

Trigger thumb

“[If] someone comes in and they say they feel like their thumb is catching or locking, [or says] ‘My thumb gets stuck down and I have to open it up in the morning,’ ” trigger thumb is the most likely cause, Barr explains. This condition, caused by problems with the tendon-and-pulley system that flexes the thumb, can be painful, she says.

The condition is easy to diagnose with a physical exam, she says. “I can feel it when I have you move your thumb up and down.”

While exact causes aren’t clear, trigger thumb and other forms of trigger finger, are more common in people with diabetes or rheumatoid arthritis, she says. Certain kinds of hand overuse may also increase the risk, Huffstutter says: “We see that in people who may use their hands a lot with gardening, especially if they don’t wear gloves, and they’re constantly irritating those tendons.”

The main treatment, Barr says, is corticosteroid injection. One or two shots work for most people, she says. If they don’t, surgery is often recommended to get the thumb to work properly again.

Carpal tunnel syndrome

This common condition can cause pain or numbness, and weakness, not only in your thumb, but in other fingers, most often the index and middle fingers, along with the thumb side of the ring finger, Huffstutter says. It happens when something irritates or puts extra pressure on a nerve that runs through a space in your wrist. It’s linked to repetitive motions, like swinging a hammer or typing, and to conditions including rheumatoid arthritis, diabetes and obesity.

To diagnose carpal tunnel syndrome, Barr says, doctors start by looking for something called Tinel’s sign: “If we tap your wrist, you’ll get an electric zing sensation in your fingers.”

You might also get some imaging tests.

According to Cleveland Clinic, treatments can include:

• Wearing a splint at night
• Physical therapy
• Over-the-counter pain relievers
• Corticosteroid shot
• Surgery

Carpal tunnel syndrome can be seen in people who have additional causes of thumb pain, including trigger thumb and CMC arthritis, Barr notes. “They’re not mutually exclusive.”

De Quervain’s tenosynovitis

Pain that radiates from your wrist to your thumb and gets worse when you grip or pinch objects could be caused by this tendon problem. It happens when a tendon or a sheath around the tendon swells or thickens.

It’s often seen in people with jobs or hobbies that involve a lot of tight gripping, like tennis, hammering or gardening, according to Cleveland Clinic.

To diagnose it, Huffstutter says, your doctor may suggest something called the Finkelstein test. You place your thumb in your palm, grasp it with your other fingers, and bend your wrist in a way that will cause pain if you have the condition, he says.

Barr says treatment usually starts with occupational therapy and splinting. “If that doesn’t work, we’ll try corticosteroid injections,” she says. Such measures work most of the time, she says.  But when they don’t, she says, “we can do a small surgery” to correct the problem.

Thumb injuries

Barr says she sees “a lot of thumbs caught in car doors,” and people who break their thumbs by hitting them too hard against something. Most often, she says, people injure thumbs in falls. One type of thumb ligament injury is known as skier’s thumb — because one way it can happen is when you fall holding ski poles.

The fix for an injury depends on whether a bone is broken and whether ligaments are stretched or torn, Barr says. The first diagnostic step is usually an X-ray, she says. Many, but not all, injuries can be managed without surgery, she says.