Mobile Thumb; Causes, Symptoms, Diagnosis, Treatment

Mobile Thumb; Causes, Symptoms, Diagnosis, Treatment

Mobile thumb is a common and overuse injury that causes the pain, numbness, & tingling sensation in the thumb. The pain is increased during operating smartphone, cell phone & operating computer. The thumb is a wonderful creation in our body, which is used so much in a day-to-day life for operating the smartphone, computer counting money & day to days life. Thumb imprints are taken as a proof of identity till now. It is not until thumb starts hurting that we realize its true value. It is an important part of our body, that we are forgotten it.T he keyboard of mobile phones are so small that most people exclusively text with their thumbs. Unfortunately, the thumb is the least stable joint in the hand, which is forced into an unnatural position- that is a cramped position in which the tendons and muscles that work the thumb are at an odd angle of pull. But these tendons or muscles of the thumb are very strong but are not designed for the intensive repetitive activity in cramped positions that are required to handle smartphones. When you add frequency of movement to that, muscles can be strained to cause aches and pain.

Anatomy of Mobile Thumb

The thumb is formed of three bones. The distal phalanx has the nail attached to it and is separated from the proximal phalanx by the Inter-Phalangeal Joint (IJP). The proximal phalanx is connected to the 1st metacarpal bone by the MetaCarpo-Phalangeal Joint (MCPJ). Both the IJP and MCPJ are simple hinge joints, essentially only allowing forward and backward movements (flexion and extension).

The thumb (or 1st) metacarpal bone sits on the trapezium, which is one of the eight wrist bones (carpal bones). This joint is called the 1st carpo meta-carpal joint (CMCJ) and is a multi-axial joint allowing movements in all directions, such that you can rotate your thumb in a circle. It is this large range of movements of this joint which is largely responsible for developing arthritis of your CMCJ.

The trapezium sits up against two other bones in your wrist, the scaphoid and trapezoid bones. Together these three bones form the Scapho-Trapezio-Trapezoid Joint (STT joint or STTJ). This joint can also be involved with arthritis, or rarely can be affected by isolation.

Causes of Mobile Thumb

So it is no surprise that many of us suffer from sore thumbs and wrists as a result of texting mobile. It is also noted that chronic texters are experiencing acute discomfort in their wrists, arms, shoulders, and neck & ranging from injury to disease, and it could even be caused by the excessive use of modern technology. Find out what’s causing your thumb pain below.

Cellphones – Your thumb can be damaged by constant typing on your mobile device. This injury is referred to as a repetitive stress injury, or more commonly, “Blackberry Thumb,” and can cause pain in the thumb joint. Common causes are following

  • Play a lot of video games
  • Use or hold a cell phone for long periods of time
  • Type a lot, use a mouse, or a computer often
  • Have injured their wrist
  • Have rheumatoid arthritis or other inflammatory arthritis
  • The repetitive and forceful hand gripping
  • Gitters & harmony playing
  • Tennis
  • Throwing a frisbee
  • Opening a jar
  • Using a hammer
  • Gardening
  • Writing for extended periods
  • Sewing by hand
  • Knitting

Keyboards – Those who consistently use a keyboard for work or pleasure and type with both hands may develop carpal tunnel syndrome, causing thumb joint pain or numbness. Regular use of keyboards may also cause joint pain similar to that experienced with De Quervain’s tenosynovitis.

Bowler’s Thumb Resulting in Thumb Pain – This is a painful condition of the thumb caused by continuous pressure or compression of the digital nerves. The pinch or irritation of the nerve causes abnormal sensory and motor sensation. Sensory symptoms are tingling and numbness, while abnormal motor symptoms are the weakness of thumb muscles resulting in difficulties in flexion and extension.

Thumb Pain Caused By Mallet or Baseball Finger – This is a painful condition of the thumb caused by damage to the extensor tendons of the thumb. The tendon damage causes joint deformity. The injury is not common and results when the object strikes exactly at the tip of the thumb.

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Bennett fracture – A Bennett fracture at the base of the thumb—most often caused by a fall or a hard punch—can cause severe joint pain and swelling.

Rolando fracture – Another fracture found at the base of the thumb, although a Rolando fracture is more severe as it occurs when the base fractures into multiple pieces. Rolando fractures almost always need surgery, and although they are rare, thumb pain can last for months afterward because of pre-mature arthritis.

Extra-articular fracture – This type of fracture is much less severe as it is a simple fracture to the shaft of the small bones known as phalanges. It usually doesn’t require surgery and heals without any invasive procedures.

Ligament injury – An injury to the ulnar collateral ligament, or UCL, is a common result of some sports and is known as “gamekeeper’s thumb,” or “skier’s thumb.” Falling on the thumb stretches the ligament and causes damage that results in swelling, joint pain, and severe bruising at the base.

Thumb dislocation – There are two major joints within the thumb that can become dislocated: the carpometacarpal joint (CMC) found at the base of the thumb, and the inter-phalangeal joint found between the phalanges. Dislocation of the CMC is more common, and pain is felt when the patient attempts to move the thumb, though there is less swelling than what occurs with other types of injuries.

Traumatic causes of thumb pain

  • Bite or sting injuries
  • Broken bones
  • Burns
  • Dislocation of bones
  • Nerve root compression due to a herniated disc
  • Nerve entrapment or compression, such as of the ulnar nerve
  • Overuse injury
  • Sprains and strains
  • Tendon rupture

Inflammatory causes of thumb pain

  • Abscess
  • Cellulitis (infection of the skin and underlying tissues)
  • Gout (the type of arthritis caused by a buildup of uric acid in the joints)
  • Osteoarthritis
  • Osteomyelitis (bone infection)
  • Rash
  • Rheumatoid arthritis (the chronic autoimmune disease characterized by joint inflammation)
  • Tendinitis

Neuromuscular causes 

  • Carpal tunnel syndrome
  • Cerebral palsy
  • Dermatomyositis (a condition characterized by muscle inflammation and skin rash)
  • Raynaud’s disease (spasms of small blood vessels of the fingers and toes, reducing blood circulation; has no known cause)
  • Raynaud’s phenomenon (spasms of small blood vessels of the fingers and toes, reducing blood circulation; secondary to another condition, such as an autoimmune disease)

Other causes of thumb pain

Other types of chronic diseases and conditions can lead to thumb pain. These disorders include:

  • Benign and malignant tumors
  • Blood clots
  • Diabetes (chronic disease that affects your body’s ability to use sugar for energy)
  • Peripheral artery disease (PAD, also called peripheral vascular disease, or PVD, which is a narrowing or blockage of arteries due to a buildup of fat and cholesterol on the artery walls, which limits blood flow to the extremities)
  • Transient ischemic attack (temporary stroke-like symptoms that may be a warning sign of an impending stroke)
  • Vasculitis (inflammation of the blood vessels, which can lead to atherosclerosis, stroke, heart attack, and other cardiac conditions)

Symptoms of Mobile Thumb

  • The symptoms include fatigue of thumb, swelling in the side of back of the wrist, pain at the base of the thumb, aggravated by thumb use, tenderness if you press on the base of the thumb, difficulty with tasks such as opening jars, turning a key in the lock etc., stiffness of the thumb and some loss of ability to open the thumb away from the hand, difficulties in functional activities with limited movements etc.
  • Pain may be felt over the thumb side of the wrist. This is the main symptom. The pain may appear either gradually or suddenly. Pain is felt in the wrist and can travel up the forearm. The pain is usually worse when the hand and thumb are in use. This is especially true when forcefully grasping objects or twisting the wrist.
  • Snapping/popping sensation when moving the thumb
  • Swelling or bump in the palm
  • Inability to fully flex the thumb
  • Swelling may be seen over the thumb side of the wrist. This swelling may accompany a fluid-filled cyst in this region.
  • The pain in the thumb can be described as a sharp, dull, burning, or throbbing pain, which varies in intensity ranging from moderate to extremely severe.
  • In few cases pain felt over thumb is a referred pain. The pain felt in a thumb may be caused by the disease or injury of the spinal cord or pinched nerve at shoulder, elbow or wrist.
  • A “catching” or “snapping” sensation may be felt when moving the thumb.
  • Pain and swelling may make it difficult to move the thumb and wrist.
  • Locking in the bent position, requiring help from the other hand to straighten
  • Pain and stiffness when bending
  • Soreness at the base of the thumb
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Diagnosis of Mobile Thumb

  • X-ray of the thumb to identify any fracture as a cause for pain in the thumb
  • Ultrasound examination
  • An EMG (electromyogram) – to check the nerves going to your thumb
  • Magnetic resonance imaging (MRI) – By using radio waves, an MRI creates a 3-D image of your thumb. It can show tumors, growths, and even damage to bones and ligaments.
  • Computerized tomography (CT scan) – A CT scan uses X-rays to create a 3-D image. With the help of a dye injected into your body, it can show damage to soft tissue as well as issues with your bones.

Treatment of Mobile Thumb

There are a variety of treatment options for dealing with thumb joint pain, though it is important to seek the advice of a medical professional before beginning any treatment regimen to ensure you do not worsen your condition.

Rest – One of the most important things you can do for any joint injury allows the affected area to rest. Refrain from using the thumb as much as you can so it has time to recover and heal properly.

Ultrasound – As part of a physical therapy regimen, ultrasounds can be used to help raise the temperature of the affected tissue and increase healing.

Stretching – Certain stretches can prove to be beneficial for thumb joint pain. Some of the most common ones are thumb abduction stretches, which require you to gently pull your thumb away from your palm with the opposite hand for approximately 20 seconds

Splinting the thumb – holds the thumb in positions that don’t cause pain

  • Deep tissue massage
  • Denervation of the 1st CMCJ
  • Physiotherapy – where manipulation, massage, and exercises are used to improve the movement and function of your hand.
  • Occupational therapy  if you’re struggling with everyday tasks and activities, either at work or at home, an occupational therapist will be able to give you practical support to make those tasks easier

Medicine for Mobile Thumb

  • Analgesics: Prescription-strength drugs that relieve pain but not inflammation.
  •  Antidepressants: A Drugs that block pain messages from your brain and boost the effects of endorphins (your body’s natural painkillers).
  • Medication – Common pain remedies such as aspirin, acetaminophen(Tylenol), ibuprofen (Advil, Motrin), and naproxen can offer short-term relief. All are available in low doses without a prescription. Other medications, including muscle relaxants and anti-seizure medications, treat aspects such as muscle spasms and damaged nerves.
  • Corticosteroid injections – Your doctor will inject a steroid such as prednisone into your thumb joints. Steroids make inflammation go down. However, because of side effects, they are used sparingly.
  • Anesthetics – Used with precision, an injection of a “nerve block” can stop the pain for a time.
  • Muscle Relaxants –  These medications provide relief from spinal muscle spasms.
  • Neuropathic Agents –  Drugs(pregabalin & gabapentin) that address neuropathic—or nerve-related—pain. This includes burning, numbness, and tingling.
  • Opioids –  Also known as narcotics, these medications are intense pain relievers that should only be used under a doctor’s careful supervision.
  • Topical Medications – These prescription-strength creams, gels, ointments, patches, and sprays help relieve pain and inflammation through the skin.
  • Calcium & vitamin D3 – to improve bones health and healing fracture.
  • Glucosamine & diaceirne – can be used to tightening the loose tension and regenerate cartilage or inhabit the further degeneration of cartilage.
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Thumb injuries are very common and can be caused by anything from too much texting to carpal tunnel syndrome. If the joint pain is persistent or concerning, contact your physician to receive a proper diagnosis and prevent any further complications.

Surgery for Mobile Thumb

Ligament Reconstruction and Tendon Interposition (LRTI)

In use for more than 40 years, LRTI is the most commonly performed surgery for thumb arthritis. The arthritic joint surfaces are removed and replaced with a cushion of tissue that keeps the bones separated. To accomplish this, surgeons remove all or part of the trapezium bone in the wrist.

Ligament Reconstruction

This procedure stabilizes the CMC joint by removing a portion of the damaged ligament and replacing it with a piece of the patient’s wrist flexor tendon.

Hematoma and Distraction Arthroplasty

In this simple, somewhat controversial procedure, surgeons remove the trapezium bone in the wrist and, with a wire, temporarily immobilize the thumb. The wire is removed six weeks later. The idea is that, without the constant friction caused in part by the trapezium, the body can heal itself.

Total Joint Replacement (Arthroplasty)

Like hip or knee replacement, this procedure removes all or part of the damaged thumb joint and replaces it with an artificial implant. Early implants were made of silicone. Surgeons now use metal or pyrocarbon prostheses and cushioning synthetic spacers that sit between the bones.

Fusion (Arthrodesis)

Arthrodesis eliminates pain by fusing the bones in the joint together. Surgeons create a socket by hollowing out the thumb’s metacarpal bone and then shaping the trapezium into a cone that fits inside the socket. A metal pin holds bones together to maintain proper alignment and prevent movement while the bones fuse.

Prevention

  • Avoiding activities that cause pain, if possible
  • If texting starts to hurt, stop and rest. Use the other hand or call instead
  • Vary the use of hands and digits
  • Do not text more than a few minutes without a break
  • Do not write long messages
  • Wrap an ice pack with thin cloth or kitchen roll and apply over the sore area for 10 mins on, 10mins off, repeat for three times and a couple of session during the day for a couple of days
  • Analgesics may give some relief
  • Gentle massage and stretching will improve flexibility and reduce the discomfort
  • Strength and endurance exercises of your forearm and hand muscles
  • Using a splint to support the thumb and wrist

 Complication

  • Infection
  • Stiffness or pain in the finger
  • A tender scar
  • Nerve damage (if a nerve is damaged during surgery, you may never recover the full sensation in the affected area)
  • Tendon bowstringing, where the tendon is in the wrong position
  • Complex regional pain syndrome (CRPS), which causes pain and swelling in your hand after surgery – this usually resolves itself after a few months, but there can be permanent problems
  • Long-term pain and swelling in the joint, known as traumatic arthritis
  • Weakness in the finger
  • Permanent inability to straighten the finger
  • Deformity of the joint
  • Damage to adjacent structures
  • Complex regional pain syndrome (CRPS)
  • Cold intolerance after finger injury or surgery

Cold intolerance is very common after the injury to or procedures on your fingers, especially the following replantation. The reason for cold intolerance is not clear but causes an exaggerated response to cold.

References

Mobile thumb

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