What Causes Thumb Pain? 7 Reasons Your Thumb May Hurt

One of the biggest advantages humans have over most other animals is our opposable thumbs.

These “handy” digits allow us to grab objects and better manipulate the environment around us. But because of this, our poor thumbs are also prone to overuse and wear and tear—which can eventually cause them to be in pain.

“We use our hands, over and over again,” says occupational therapist Karen Jacobs, clinical professor and director of the online post-professional doctorate in occupational therapy (OTD) program at Boston University, and spokesperson for the American Occupational Therapy Association (AOTA).

“A lot of times, what happens with our hands and specifically our thumbs is that we use them incorrectly as tools,” she says. This can lead to chronic pain.

Thumb pain, and hand pain in general, is very common. According to a study of over 2,000 participants published in 2017 in the journal Arthritis and Rheumatology, people have a nearly 40 percent lifetime risk of arthritis in the hands—and that’s just one cause of thumb pain. “It’s related to age. We have a tendency to see it after age 40,” Jacobs says.

Women are also more at risk, possibly because they are more prone to some of the conditions that lead to thumb pain.

Here’s a look at some of those causes and how you can manage the pain, or even prevent it from happening.

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Thumb arthritis

Arthritis is one of the leading causes of thumb pain. Osteoarthritis, the wear-and-tear type, affects the bottom thumb joint, causing the cartilage to wear away and the bones to rub together, which leads to pain.

“Thumb CMC (carpometacarpal) joint arthritis often presents with pain at the base of the thumb, where the thumb joins the wrist,” says Julie Adams, MD, professor of orthopaedic surgery at the University of Tennessee College of Medicine–Chattanooga and spokesperson for the American Academy of Orthopaedic Surgeons (AAOS). “Pain is often worsened with gripping, pinching, or grasping activities and is often better with rest.”

This arthritis causes “a lot of discomfort in all of the activities of daily living that we do, from opening a jar, writing, getting dressed to holding onto objects,” Jacobs says. Yours may be a sharp pain or achy discomfort.

In addition to pain after using your hand for a while, osteoarthritis may lead to swelling, tenderness, or loss of strength. Rheumatoid arthritis, an inflammatory autoimmune disease that affects the joints, can cause similar symptoms, Jacobs says.

Your doctor may diagnose thumb arthritis with a physical examination, including holding the joint while moving the thumb and listening for a grinding sound.

“Women are more likely to get thumb CMC joint arthritis, and incidence increases with age,” Dr. Adams says. “We believe women may be more likely to have base-of-thumb arthritis in part because of hormonal differences that result in increased laxity of the joints in some women.”

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De Quervain’s tendinosis

Named for the physician who first described it, de Quervain’s tendinosis (also called tenosynovitis) occurs when the tendons that go from the wrist to the thumb are swollen, or constricted if the sheath around them is swollen.

“When you move your thumb or put pressure in that area, it really affects the tendons that go to your thumb, and you can see some swelling,” Jacobs says. “You might have some pain, but that could even be along your wrist too. Some of the symptoms are very similar to what I described with arthritis: swelling, tenderness, decreased strength, and decreased range of motion.”

Another sign of de Quervain’s tendinosis? A “catching” feeling when you use your thumb.

Why this tendon problem develops is poorly understood, but it likely has to do with repetitive motions. “This can happen out of the blue,” Jacobs says.

Or it can come on gradually. It tends to affect women ages 30 to 50, especially those who repetitively use their thumbs to lift babies or children. (Hence its nicknames: “mommy thumb” or “mother’s wrist.”)

It’s also sometimes called “gamer’s thumb” or “texter’s thumb,” as people who engage in those activities may also develop it.

Doctors use something called the Finkelstein test to help diagnose de Quervain’s: making a fist with your thumb enclosed and bending your wrist toward your pinkie. If you have pain between the base of your thumb and your wrist, you may have de Quervain’s.

(Related: What Causes Lower Back Pain in Women?)

Trigger finger

Known medically as stenosing tenosynovitis, trigger finger causes pain when your thumb feels like it’s locked in a bent position, as if you were pulling a trigger. It’s one of the most common causes of hand pain, affecting 2 to 3 percent of people and up to 10 percent of people with diabetes. People with rheumatoid arthritis may also be more prone to the condition.

“Trigger thumb involves swelling of the tendon that bends the thumb. Patients will get soreness over the thumb on the palm side, where it meets the rest of the hand, and may experience catching, locking, or stiffness of the digit,” Dr. Adams says.

In severe cases of trigger finger, you may have to straighten your thumb with your other hand. The condition can also be audible. “You’ll hear a clicking sound. The thumb gets sort of stuck, and you get this popping sensation,” Jacobs says. “I’ve seen it in clients, and you can actually hear the click.”

You might also develop a painful node, which can make mobility more difficult.

Carpal tunnel syndrome

Although this condition really affects the wrist on the palm side, you may experience pain or numbness that radiates to the thumb and first few fingers.

The carpal tunnel is a narrow pathway in the wrist surrounded by ligaments and bones and containing the median nerve. With carpal tunnel syndrome, that nerve gets compressed. “So what you’ll have is decreased sensation, and some pain and numbness to the thumb, index finger, middle finger, and ring finger,” Jacobs says.

Your doctor might perform Tinel’s test, a tapping on the palm side of your wrist, over the median nerve, to see if your fingers tingle and to help diagnose carpal tunnel.

Repetitive use (such as typing or activities that keep the wrist in a flexed position), diabetes, and rheumatoid arthritis can all lead to carpal tunnel syndrome. It’s also common in pregnancy due to swelling.

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Fractures and tears

Of course, if you break your thumb it will be painful. This is more likely to happen in winter, with black ice leading to falls. “What do you put out to protect your fall most of the time?” Jacobs asks. “Your hands and your thumb gets caught in that, so we see some fractures.” You may need to keep the bone immobilized in order for it to heal; untreated thumb breaks can lead to arthritis later.

In addition to broken bones, a fall can also lead to a sprain, which is a stretching or tearing of ligaments. For example, skier’s thumb, an injury to a ligament on the inner side of the thumb, is so named because it often happens when skiers fall with a ski pole in their hand.

Ganglion cysts

If you develop a ganglion cyst on or near your thumb, you can experience pain when you move the joint. These cysts are the result of accumulated synovial fluid—the stuff that keeps joints (including those in the hands and knees) lubricated. With a ganglion cyst, you may notice a lump under the skin.

Ganglion cysts can go away on their own. If the pain is severe and affects joint mobility, you may require further treatment, like having your cyst drained via needle and syringe.

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Unhealthy thumb habits

Many of these conditions have at their root repetitive, unhealthy thumb movements. There’s a whole host of actions that can contribute to the problem, Jacobs says, including wearing too-tight gloves to protect against winter’s chill (or gloves to protect against Covid-19), picking up bags using your thumb, and wearing thumb rings.

And while computer keyboards aren’t as much of a risk (after all, your thumb isn’t used for anything but the space bar), your phone is a different issue.

“I see people using their thumbs for typing completely, and that’s that’s very problematic,” Jacobs says. To avoid overuse, she suggests typing with other fingers or using voice recognition software for texting or email on your phone. “It’s little things that we have to rethink in order to change some of our behaviors, because we’re doing many of these unconsciously.”

When to see a doctor

If you had a fall and are now having sudden thumb pain, you’ll obviously see your doctor, but if pain comes on gradually it can be hard to know when to make the call. “What I would share would be for someone who’s having symptoms related to the thumb to first talk to their physician—that is your best start,” Jacobs says. Your doctor can refer you to a specialist or an occupational therapist (OT).

“Symptoms that wake the patient from sleep, rapid progression of symptoms, or other such symptoms can be worrisome and should prompt earlier evaluation by a physician,” Dr. Adams says.

Specifically, “patients who have a ‘locked’ trigger thumb—in which they need to pull it free with the other hand—or persistent and bothersome symptoms, or patients with thumb CMC joint arthritis that is not adequately treated with home treatment measures, should visit their friendly local hand or orthopedic surgeon for a clinical examination.”

(Related: How Pain Management Specialists Can Help You Treat Chronic Pain)

Diagnosing thumb pain

Your doctor will take your health history and do a physical exam to diagnose you. The exam might include some of the pain tests mentioned above.

Occasionally, X-rays or other studies are needed. Interestingly, in the case of thumb arthritis, “although many patients have X-ray evidence of arthritis, not all of these patients will have symptoms, and sometimes symptoms will get better over time even though the X-rays show arthritis,” Dr. Adams says.

Treatment for thumb pain

“Different treatment options will depend on the condition,” Dr. Adams says. “For some conditions, we treat with rest, ice or heat (whichever feels better), over-the-counter medications, activity modifications, and brace or splinting. For others, steroid injection or surgery is offered.” If you do need surgery, it’s usually on an outpatient basis. In general, your doctor will recommend less-invasive measures first.

“We call this ‘symptomatic care,’ meaning that patients may try to treat the symptoms with a variety of low-risk interventions that are designed to improve pain,” Dr. Adams says. “Patients may consider use of a splint or gently wrapping the thumb with a stretchy wrap that provides support and may help relieve pain. Sometimes limiting motion of the joint can improve pain.”

(Related: Everything You Need to Know About Chronic Pain)

Modifications to prevent thumb pain

There are ways to modify activities that cause pain. “There are lots of compensatory strategies we can use to help us have less pain,” Jacobs says. “What kind of adaptive tools could you use? For example, holding a manual can opener can put your thumb and wrist in an awkward position, so get an electric can opener. If you’re holding a knife and that feels uncomfortable with your thumb, think about using a food processor.”

Switching up the way you perform the activities of daily living can reduce your pain.

Thumb exercises

Certain exercises may also be recommended by an OT. “For thumb CMC joint arthritis, patients may benefit from selective strengthening exercises of the first dorsal interosseous muscle [the fleshy part between your thumb and fingers], which are often taught by a hand therapist,” Dr. Adams says. “This involves altering the way a person uses the thumb to pinch and may result in pain relief.”

Before you try an exercise, check with your doctor—and don’t do them if you have pain. Here are a few moves Jacobs suggests:

• Make a fist
• Bend your thumb to touch the base of the little finger
• Touch the tip of the thumb to the nail of each finger
• Make an ‘O’ with your thumb and other fingers.

Ask your doctor about seeing an OT to help with these exercises, as well as to learn other ways to improve your thumb pain

The last word

Thumb pain can be connected to several causes tied to repetitive movement. In most cases, you can use over-the-counter painkillers for relief. However, for causes tied to more complicated medical conditions, it’s important to consult a doctor to find the best treatment plan for you.

Now that you know about thumb pain, read about your piriformis and stretches you can do to treat buttock pain.