Pain when you move your thumb?
There are many causes of thumb pain, but one common one is De Quervains Tenosynovitis. De Quervains Tenosynovitis presents as a sharp pain just below your thumb on the side of your wrist, made worse when moving your thumb out from your hand. You may have some swelling and pain can be felt up the forearm where the tendons travel. In some cases, a squeaking or cracking sound can be heard when moving the thumb, known as crepitus.
What is it?
De Quervains Tenosynovitis is inflammation of the synovium (outer lining) in the tendons that move your thumb backwards and out to the side, known as extensor pollicis longus and abductor pollicis brevis.
How is it caused?
This is usually due to repetitive thumb movements, especially moving it out the side and when bending your wrist inwards so your thumb comes close to your forearm, such as when using a hammer or when picking up a baby. Also, common in sports with heavy use a racquet or bat, such as cricket and tennis. Like many tendinopathies, when these movements are done more frequently than normal the tendons become overloaded, strained, and breakdown starts to occur.
Physiotherapy can help accurately diagnose your thumb pain using specific tests. Treatment in the acute stages consists of electrotherapy modalities and splinting or tapping techniques to reduces the inflammation and stop the aggravation of the tendons. Once your symptoms have settled, myofascial release techniques, including deep tissue massage, trigger point therapy and dry needling can be used to regain optimal tendon compliance and reduce tension.
Changing your grip and wrist position during functional movements an also help reduce your symptoms by unloading the tendons. This can be done by using a thicker handle when using tools, or on your racquet/bat, using a rubber grip on your pen, and avoiding side bending of your wrist by keeping it in a neutral position when picking objects up repetitively, such as a baby.
In the later stages stretches and a specific strengthening program will be prescribed to load the tendons and restore their tensile strength to enable sufficient healing and prevent re-aggravation to get you back to full function.