Thumb Pain/Injury
What are some common thumb injuries?
In the abstract, we humans know that the opposable thumb is one of our claims to fame, but we may not truly appreciate the thumb’s importance until its function is impaired by a painful, debilitating thumb injury. A thumb can be injured by a fracture of one of its three bones, but injuries to the tendons, ligaments and muscles that control the thumb are also common. These can occur as the result of repetitive small injuries, none significant in itself, sustained over time.
What are the common causes of thumb injuries?
Short of an outright bone fracture or dislocation, thumb injuries tend to involve damage to one of the ligaments that attach the thumb’s muscles to its bones and to the other bones of the hand and wrist. Some injuries can be traced to discrete events. For example, when a person breaks a fall with an outstretched arm and the thumb is extended, the stress may be sufficient to tear or detach the ulnar collateral ligament. This injury is known as skier’s thumb, so named because it is characteristic of a fall with the thumb entangled in a ski pole.
A similar condition, gamekeeper’s thumb, involves damage to the same ligament but the damage results from repetitive small injuries. As damage accumulates, the ligament becomes thin and stretched, making treatment difficult. Gamekeeper’s thumb received its name in a 1955 study of 24 Scottish gamekeepers. The condition was attributed to the common practice of breaking game animals’ necks by applying pressure with the thumb and index fingers.
Another condition that occurs over time is mommy thumb, another name for De Quervain’s tendinitis. As a result of repeated lifting, as when a mother lifts an infant, the tendons that travel from the forearm to the thumb can become painfully inflamed.
What are the symptoms of the common thumb injuries?
Thumb pain is almost invariably a symptom of thumb injuries, although the site and persistence of the pain varies depending on the condition. Gamekeeper’s thumb is characterized by pain directly above the affected ligament and grasping or pinching movements may be particularly painful. Mommy thumb results in wrist and forearm pain in the area below the base of the thumb.
Thumb numbness can also be present, especially in cases of repetitive stress injuries like those associated with carpal tunnel syndrome.
Treatment Options
What are the non-surgical treatment options?
Non-surgical treatment almost always involves resting the injured thumb. Rest is often supplemented by the use of an immobilizing brace or splint and by the use of non-steroidal anti-inflammatory medication.
What are the surgical treatment options?
Surgery can be employed to remove bone spurs that appear in chronic deterioration of the thumb and to repair torn or detached ligaments. In skier’s thumb, torn ligaments can be sutured directly to the bone if they cannot be repaired otherwise, but surgical treatment of gamekeeper’s thumb can be difficult because of the stretching of the affected ligament. In that case, a simple repair may be technically impossible, but the surgeon may be able to make a new ligament from a tendon using metal anchors to compensate.
In cases of mommy thumb, the channel through which the relevant tendons travel can be enlarged through surgery, relieving the irritation that inflames those tendons.
Thumb Ulnar Collateral Ligament (UCL) Injury Animation Video
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