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Sports Medicine

Pain in thumb

07/13/2007

Question:

I cannot bend my thumb at the first joint. If it bends, sort of pops and will hurt a great deal. The pain feels as if the thumb is burning. The underside of the thumb hurts. There is no swelling or discoloration. It also happened literally overnight---I woke up one morning with it stiff and in pain. X-rays were taken and nothing was found. It`s been this way for roughly three months. It hurts when I press the botton side of the thumb and the area along the lower joint.

Answer:

There are several possible explanations for your pain. 

1) Trigger finger: This is an inflammation of the tendon as it slides through the pulley sheath of the finger.  The enlarged area is often tender and it can get stuck or pop as it slides through the pulley.  This can be treated with local steroid injections or surgery.

2) Sesamoiditis: There are small accessory bones occasionally in the thumb that can get irritated and inflamed and cause these symptoms.

3) Arthritis: Irritation of the joint capsule and destruction of the cartilage in the joint with narrowing of the joint space can cause these symptoms.

4) Gout: Inflammation of the joint from a deposit of urate crystals in the joint.

There are many possible explanations many of which would not have any x-ray findings.  I would recommend re-evaluation or a second opinion to help you determine the exact cause of your symptoms and proper treatment course.  I hope this helps.

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Response by:

Charles Webster, MD
Assistant Professor
College of Medicine
University of Cincinnati