From the Guidelines
When experiencing thumb pain, it is crucial to ask your healthcare provider about the likely cause, severity, and recommended treatments, considering the latest guidelines from the European League Against Rheumatism (EULAR) 1. Important questions to ask include: What is the likely cause of my thumb pain? Is it due to arthritis, tendonitis, or an injury? How severe is my condition? What treatments are recommended for my specific situation? For arthritis, medications like topical NSAIDs, which are preferred over systemic treatments due to safety reasons 1, might be suggested.
Some key considerations based on the EULAR recommendations 1 include:
- Education and training in ergonomic principles, pacing of activity, and use of assistive devices, which should be offered to every patient 1
- Exercises to improve function and muscle strength, as well as to reduce pain, which should be considered for every patient 1
- Orthoses, which should be considered for symptom relief in patients with thumb base OA, with long-term use advocated 1
- Topical treatments, which are preferred over systemic treatments because of safety reasons, with topical NSAIDs being the first pharmacological topical treatment of choice 1
It is also essential to ask about the expected timeline for recovery and if physical therapy would be beneficial. Inquire whether splinting or bracing is recommended and for how long, typically worn during painful activities or at night. Ask if there are specific activities you should avoid and what exercises might help strengthen the thumb. For persistent pain, ask about steroid injections or if surgical intervention might eventually be necessary, considering that surgery should be considered for patients with structural abnormalities when other treatment modalities have not been sufficiently effective in relieving pain 1. Understanding the diagnosis helps guide appropriate treatment—for example, osteoarthritis at the base of the thumb requires different management than De Quervain's tenosynovitis or trigger thumb. Being specific about when the pain occurs (during certain movements, at rest, or after activities) provides valuable diagnostic information for your healthcare provider.
From the Research
Thumb Pain Questions to Ask
When experiencing thumb pain, there are several questions to ask to determine the cause and appropriate treatment. Some of these questions include:
- What are the symptoms of basal thumb arthritis, and how is it diagnosed? 2
- What are the treatment options for basal thumb arthritis, and when is surgery necessary? 2
- How can soft tissue injuries, such as those affecting the thumb, be managed using the PRICE principle? 3
- What are the benefits and risks of corticosteroid injections for tendinopathies, including those affecting the thumb? 4
- What pharmacologic therapies are available for acute pain management, including thumb pain? 5
- How effective is the combination of ibuprofen and paracetamol in preventing the persistence of acute musculoskeletal disorders, such as thumb pain? 6
Potential Causes of Thumb Pain
Some potential causes of thumb pain include:
- Basal thumb arthritis, which can cause pain and stiffness in the thumb joint 2
- Soft tissue injuries, such as strains or sprains, which can be managed using the PRICE principle 3
- Tendinopathies, which can be treated with corticosteroid injections or other therapies 4
- Acute musculoskeletal disorders, which can be managed with pharmacologic therapies such as acetaminophen or NSAIDs 5
Treatment Options for Thumb Pain
Treatment options for thumb pain may include:
- Activity modifications, rest, and nonsteroidal anti-inflammatory drugs for basal thumb arthritis 2
- The PRICE principle (protection, rest, ice, compression, and elevation) for soft tissue injuries 3
- Corticosteroid injections or other therapies for tendinopathies 4
- Pharmacologic therapies such as acetaminophen or NSAIDs for acute pain management 5
- The combination of ibuprofen and paracetamol for preventing the persistence of acute musculoskeletal disorders 6