Senior Citizen's Guide digital books
Senior Citizen's Guide to Baltimore

Thumb Pain
A Common and Treatable Condition

The human thumb is a complex structure involving multiple nerves, tendons, muscles and joints. This unique joint is unlike any other in the human body.  It evolved over thousands of years as our ancestors developed and allows for many varied tasks ranging from gross manual grasp to a myriad of precise pinching tasks. Professional athletes and concert musicians all depend on this fascinating appendage.

The thumb joint is shaped like a horse’s saddle, which allows for multiple planes of motion. The “saddle” is covered with a smooth cartilage which is nature’s shock absorber. With time, stress and injury the thumb’s cartilage breaks down causing pain as raw bone contacts raw bone. Inflammation and swelling results, and deformity of the thumb will become apparent.

This problem occurs most frequently in women over the age of 40. Middle-aged men, however, often develop this condition. The exact cause is unknown, but there is a strong association with gender, genetics, previous injury and ligament laxity.

Usually, the onset of pain progresses slowly. Patients experience increasing difficulty with gripping and pinching activities. Initially, the pain often waxes and wanes with long, pain-free periods. With time, turning a key, opening a jar and gripping a golf club all grow to be more and more difficult. Next, a bump at the base of the thumb becomes apparent. Weakness increases as dexterity decreases.

When seeking medical attention, patients complain about increasing pain with gripping and pinching. An exam reveals swelling and a bump at the thumb base. The physician usually compresses and shifts the thumb to elicit a pain response. Decreasing grip and pinch strength is revealed and X-rays demonstrate joint changes. More sophisticated testing such as MRI is rarely necessary.

Non-surgical treatment consists of rest, anti-inflammatory medication such as ibuprofen, and splinting. Limited use of cortisone injections may provide varying degrees of relief. Alternative treatments such as Glucosamine-Chondroitin Sulfate, acupuncture and chiropractic manipulation have all been tried with varying degrees of success.

When these measures fail, surgical reconstruction of the arthritic joint is performed. A variety of procedures exist, but all involve removal of the arthritic surfaces and replacement with either tendon or synthetic substitutes.

In most cases, surgery is performed on an outpatient basis. Regional or general anesthesia is usually required. Patients experiencing varying degrees of discomfort often require a few days of oral prescription pain relievers. Immobilization is usually needed for six to eight weeks. Frequently, supervised physical therapy is needed for six weeks to aid in the restoration of hand function.  Patients typically require six months to recover fully with some occasionally needing a full year.

Surgical patients uniformly recover with limited complications. To date, traditional procedures involving tendon joint reconstructions have demonstrated excellent long-term durability. Revision surgery is rarely needed. Most patients find their quality of life greatly improved with nearly all returning to previous work and leisure activities.

Pain at the base of the thumb is a common and disabling condition that can be corrected. Non-invasive treatments often provide excellent pain relief. When indicated, surgical reconstruction provides uniformly excellent results.

Home    Featured Programs    Choose Local Area     Request Information
A JR Media Publication • www.jrmediallc.comSite Index