Understanding Thumb Middle Joint Pain

Bones are strong, generally tubular structures composed of a dense collagen architecture infused with calcium phosphate crystals. The central component, or marrow, or bone, is filled with tissues that produce the cellular elements of blood. Because they have to be rigid enough to support and protect the vital internal organs, bones are not intrinsically flexible enough to allow movement or locomotion. A joint is a skeletal articulation, where two separate bones are held together by strong yet flexible soft tissues that allow components of the skeleton to move when muscles on opposite sides of the joint contract or relax. These crucial soft tissues include the joint capsule and ligaments that actually connect the opposing bones, the tendons that attach muscles to the bones, the cartilage which cushions the surfaces of opposing bones, the synovial membrane which secretes the nutrients and lubricating substances that allow the joint to move smoothly and efficiently, and menisci, which are extra fibrous cushions found in various joints throughout the body.

Swelling in the joint, whether or not accompanied by pain and tenderness, is a sign of disruption in articular anatomy or function. The problem must be correctly defined before any appropriate corrective action can be taken. Therefore, the first step in the approach to joint swelling is a diagnosis (a diagnosis is simply the definition of a medical problem). The two medical disciplines specifically directed toward the study and care of disruptions in skeletal function are orthopedics, a discipline which concentrates on the surgical treatment of these disorders, and rheumatology, a specialty directed towards treatment of the medical diseases that affect the joints.

Pain in thumb joint is a fairly common medical condition. Usually, this pain is felt at the basal joint of the thumb, also referred to as the first carpometacarpal (CMC) joint. This joint is one of the most mobile and widely used joints in the body. Consequently, it is more prone to wear, tear, stress and injury than most joints. Thumb joint pain can be very disabling. It usually leads to a tingling sensation and numbness in the palms, and finger pain. It makes it difficult and painful to hold and grip things in the hands. Sometimes, the pain will also be accompanied by stiffness and tenderness of the thumb joint area.

The Causes of Pain in The Thumb Middle Joint

Arthritis

Basal joint arthritis is a leading cause of pain in thumb joint.  Arthritis causes degeneration of the synovial membrane that enhances lubrication at the joints and consequently, deterioration of the articulating cartilage at the joints. Due to the fact that the thumb joint is commonly used, deterioration occurs much faster leading to the early manifestation of basal joint arthritis and pain in thumb joint.

Injury to the thumb

Injury or trauma to the thumb is another cause of pain in thumb joint. The injury can be accidental causing a sprain or tear of the muscle tendons and ligaments of the basal thumb joint. This can lead to inflammation causing thumb joint pain. Injury can also lead to a fracture which causes a lot of pain. Repetitive stress in the thumb joint also causes tear and wear of ligaments leading to a painful condition called tendonitis.

Bursitis

Bursitis refers to the injury and inflammation of the bursa; a fluid-filled sac located in the middle of joints, that contains lubricating fluid. When the bursa at the thumb joint is injured, the lubricating fluid decreases causing friction and rubbing during joint movement, which is manifested as pain in the thumb joint.

Tendon cyst

The tendon cyst (or cysts synovial) on the hand’s bulges are filled with fluid, which is formed close to the tendons (tendon sheaths) or joints (joint capsule).

Their dimensions are extremely variable: some tendon cysts are as big as a pea; others are the size of a golf ball.

The most common sites of the tendon cysts in the hands are the wrists; however, the central part of the hands (palm and back) and the fingers can also develop these problems.

The fluid contained in the cysts is similar to the synovial fluid; it is light in color and mucus-gelatinous consistency.

Synovial cysts are painful in all those cases in which they develop near a nerve end and cause them to be crushed.

Risk Factors

Among the risk factors for the snap finger we remember:

• Sex. Thumb middle joint pain hits women more frequently.
• Age. It mainly affects individuals between 40 and 60 years.
• Previous hand injuries.
• Repeated gripping movements. If you are forced to grip with your fingers, for example for work or playing an instrument, you may be more susceptible to thumb middle joint pain.
• Health problems. You are most at risk of suffering from a snap finger if you suffer from particular disorders such as rheumatoid arthritis, diabetes, hypothyroidism, amyloidosis, gout, carpal tunnel syndrome, Dupuytren’s disease, and De Quervain syndrome.

Managing The Pain in Thumb Middle Joint

Due to the disabling nature of pain in thumb joint, it is imperative to manage and treat the pain before it gets severe. Some management options include:

Resting the thumb

Continued use of the thumb when there is pain worsens the condition and leads to more severe pain. If you are already experiencing pain, it is important to rest the thumb by restricting movement. This can be done by using a spica splint with a thumb support to immobilize the thumb. This helps in resting the joint and the inflamed area reducing the finger joint pain.

Thumb exercises

If the thumb is not fractured or severely sprained, you can use a range of exercises to lessen the pain and maintain motion. This includes thumb flexion, extension, and rotation of the thumb joint.

Use of heat and ice pads

Ice packs can be used on the inflamed basal joint to lessen the joint pain and reduce inflammation. Heat, on the other hand, will help to straighten stiffened joints.

Surgery and corticosteroid injections

In very painful cases, corticosteroid injections can be administered to lessen pain and inflammation. In very severe cases, surgery is imperative to replace, fuse or reposition the joint and resolve the pain in thumb joint.

Understanding Thumb Middle Joint Pain, Last Updated: 21/2/2018