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Causes of Pain in the Thumb and Wrist

by
author image Sharon Perkins
A registered nurse with more than 25 years of experience in oncology, labor/delivery, neonatal intensive care, infertility and ophthalmology, Sharon Perkins has also coauthored and edited numerous health books for the Wiley "Dummies" series. Perkins also has extensive experience working in home health with medically fragile pediatric patients.
Causes of Pain in the Thumb and Wrist
Man holding his wrist next to a computer keyboard Photo Credit ViktorCap/iStock/Getty Images

Overview

Thumb and wrist pain can significantly impact your daily activities. The bones, joints, ligaments and tendons in the thumb and wrist can all suffer injury or inflammation that leads to pain. Overuse and repetitive motion injuries, sport accidents, falls and aging are among the culprits that cause thumb and wrist pain. See your doctor for an accurate diagnosis and proper treatment for your thumb or wrist pain.

Arthritis

Two types of arthritis commonly affect the thumb and wrist -- osteoarthritis and rheumatoid arthritis. Osteoarthritis develops as cartilage breaks down in a joint. As this padding between the bones thins out, pain increases. Eventually the bones may rub against each other, causing severe pain. Osteoarthritis may affect one or more joints in the thumb and wrist, as well as other parts of the body. However, it does not always affect multiple joints at the same time, and the severity of joint damage varies. Rheumatoid arthritis occurs when the body mistakenly attacks healthy tissue, causing joints to break down. This condition often affects the thumb and wrist, as well as other joints in the body, simultaneously.

The carpometacarpal joint at the base of the thumb near the wrist suffers considerable wear and tear over a lifetime. This joint, known as the basal joint or thumb CMC joint, often develops arthritis early in life. Even people who don’t have arthritis in other areas may develop arthritis in this joint. Basal joint arthritis may interfere with the ability to pinch or grip with the thumb. Treatment may include anti-inflammatory medications, cortisone injections or surgery.

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Nerve Compression

In addition to powering muscles, nerves supply sensation to the skin of the thumb and wrist. Nerve compression, often caused by repetitive motion activities or direct trauma, can lead to pain in these areas. Carpal tunnel syndrome, a repetitive motion injury, develops when swelling compresses the median nerve in the wrist. Carpal tunnel injuries cause aching burning pain in the wrist, thumb or fingers, often accompanied by numbness and tingling that may extend as far as the elbow. It may be difficult to grasp with the thumb. Splints and anti-inflammatory medications help reduce swelling, however surgery may be required to relieve pressure on the nerve.

Tendinitis

Inflammation of the tendons that move the thumb and wrist can cause significant pain. This condition, called tendinitis, is typically caused by repetitive movements or direct trauma. Tendinitis can affect any tendons in the wrist and thumb. De Quervain’s tendinitis, inflammation of the tendons that pass through the wrist and into the thumb, is a common condition that causes thumb and wrist pain. Movement of the thumb may also be accompanied by a snapping or catching sensation. Splinting, antiinflammatory medications and cortisone shots are used to decrease pain in mild cases of De Quervain's tendinitis. Surgery is sometimes performed to relieve pressure on the inflamed tendons.

Ganglion Cyst

Ganglion cysts develop next to joints or tendons. Because joints and tendons need lubricating fluid to move smoothly, compartments near joints and tendon in the fingers and wrist contain thick fluid that may leak out of the compartment. Once the fluid leaks out, the thickness makes it hard to work its way back in, so a lump of fluid that can become very hard develops. A ganglion cyst on the thumb side of the back or front of the wrist can put pressure on nerves that causes pain into the thumb or wrist. Many ganglion cysts resolve on their own, while some grow into bone. Ganglion cysts may require cortisone injections, drainage or surgery.

Trauma

Thumb and wrist pain can be caused by trauma, affecting bones and ligaments in these joints. The ulnar collateral ligament, on the inside of the base of the thumb, is particularly susceptible to injury. This injury is often called "skier's thumb" or "gamekeeper's thumb." Treatment depends on the extent of ligament damage and typically includes casting or splinting to allow it to heal. However, tears in the ligament may need to be surgically repaired.

Bone fractures can cause thumb and wrist pain. Injury to the scaphoid bone, found at the base of the thumb, causes pain and tenderness on the thumb side of the wrist. Scaphoid fractures may heal with casting or may require surgical repair, depending on the severity of injury.

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References

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