Thumb Contusion Recovery Time
A thumb contusion without fracture typically heals within 1-2 weeks for pain resolution and 2-4 weeks for complete functional recovery, though thumbnail bruising may persist for several months until the nail grows out.
Expected Recovery Timeline
Acute Phase (First 72 Hours)
- Soft tissue swelling and contusion peak within the first 72 hours following blunt trauma, with metabolic changes including hypoxia and acidosis in the injured region 1
- Initial pain and tenderness are most severe during this period 1
Early Recovery (1-2 Weeks)
- Most soft tissue pain and swelling resolve within 7-14 days for simple contusions without fracture 2
- The thumb should regain functional range of motion during this timeframe, though some residual stiffness may persist 2
Complete Recovery (2-4 Weeks)
- Full functional recovery typically occurs by 2-4 weeks for uncomplicated soft tissue contusions 2
- Grip strength and pinch strength should return to baseline during this period 2
Thumbnail Considerations
- Subungual hematoma (blood under the nail) may take 3-6 months to completely resolve as the nail grows out and is replaced 2
- The discolored nail will gradually grow toward the tip and eventually be trimmed away 2
- Nail deformity may occur if the nail matrix was injured, though this is uncommon with simple contusions 2
Management Approach
Immediate Care
- Apply ice for 15-20 minutes every 2-3 hours during the first 48-72 hours to minimize swelling 1
- Elevate the hand above heart level when possible 1
- Buddy taping to the index finger may provide comfort and protection 2
Activity Modification
- Avoid activities that cause pain or stress to the thumb for the first 1-2 weeks 2
- Gradual return to normal activities as pain permits, typically beginning after the first week 2
Red Flags Requiring Re-evaluation
Seek medical attention if any of the following develop:
- Persistent severe pain beyond 2 weeks 2
- Progressive swelling or inability to move the thumb 2
- Numbness or tingling that doesn't resolve within days 2
- Signs of infection (increasing redness, warmth, purulent drainage) 2
Common Pitfalls
- Do not assume all thumb injuries are "just bruises" - if there was significant force or persistent instability, radiographs should be obtained to exclude occult fracture, particularly of the base of the proximal phalanx or metacarpal 2, 3
- Persistent pain beyond 2 weeks warrants repeat clinical evaluation and consideration of delayed imaging, as initial radiographs can miss some fractures that become apparent at 10-14 days 2, 3