Why Does My Thumb Hurt?
Understanding Common Thumb Injuries and Conditions
Thumb pain can make even simple daily activities frustrating. Opening a jar, turning a key, gripping a steering wheel, lifting a child, typing on a phone, or shaking hands can suddenly become painful. Because the thumb plays such a critical role in grip and pinch strength, injuries and arthritis involving the thumb often affect daily function much more than people initially expect.
Many patients are surprised to learn how many different conditions can cause thumb pain. Sometimes the pain develops gradually from overuse or arthritis. Other times it begins suddenly after a fall, skiing injury, sports accident, or repetitive strain. Pain at the base of the thumb, pain near the thumb side of the wrist, clicking, weakness, swelling, or instability can all point toward different underlying problems.
Dr. Chris English is a fellowship-trained hand and upper extremity surgeon treating thumb injuries and thumb pain in Layton, Ogden, Bountiful, Davis County, Weber County, and Northern Utah.
Pain at the Wrist With Thumb Movement = De Quervain’s Tenosynovitis
One of the most common causes of thumb-side wrist pain is De Quervain’s tenosynovitis. This condition involves inflammation of the tendons that help move the thumb and often develops from repetitive gripping, lifting, or overuse. It is especially common in parents lifting infants, athletes, skiers, mountain bikers, and patients who perform repetitive hand activities throughout the day.
Patients with De Quervain’s often describe sharp pain along the thumb side of the wrist that worsens when lifting objects, opening jars, gripping, or twisting motions. Some notice swelling or tenderness near the base of the thumb. Others initially believe they simply “sprained” their wrist.
Treatment may include activity modification, thumb spica bracing, anti-inflammatory medications, corticosteroid injections, hand therapy, or surgical release when symptoms persist despite conservative treatment.
Pain at the Base of the Thumb When Gripping = Thumb Arthritis (CMC Arthritis)
Pain at the base of the thumb is commonly caused by thumb carpometacarpal (CMC) arthritis. This form of arthritis develops at the joint where the thumb meets the wrist and is one of the most common arthritis conditions affecting the hand.
Patients often begin noticing pain while opening jars, turning keys, pinching, gripping, or lifting objects. Over time, weakness, grinding sensations, stiffness, and loss of pinch strength may gradually develop. Some patients notice enlargement or prominence at the base of the thumb joint.
Thumb arthritis can range from mild irritation to severe joint degeneration that significantly affects hand function and quality of life. Treatment depends on symptom severity and may include bracing, injections, anti-inflammatory medications, hand therapy, or thumb arthritis surgery in more advanced cases.
This video shows the splint that is worn for the first week after a thumb CMC arthroplasty, skiers thumb surgery and Bennett fracture surgery
Clicking and Locking of the Thumb = Trigger Thumb
Trigger thumb develops when inflammation affects the flexor tendon that bends the thumb. Instead of gliding smoothly, the tendon catches or locks as it moves through a tight pulley in the palm.
Patients commonly describe painful clicking, catching, or locking of the thumb. Some wake up with the thumb stuck bent down and must manually straighten it with the other hand. Symptoms are often worse in the morning and may progressively worsen over time.
Trigger thumb can sometimes improve with splinting, activity modification, or corticosteroid injections. When symptoms persist, trigger thumb release surgery is commonly performed as a relatively quick outpatient procedure designed to restore smooth tendon motion.
Middle Knuckle Pain After Trauma = Skier’s Thumb (UCL Tear)
Skier’s thumb refers to injury of the ulnar collateral ligament (UCL) at the base of the thumb. This ligament is important for pinch strength and thumb stability and is commonly injured during skiing falls, sports injuries, mountain biking crashes, and other trauma where the thumb is forcefully bent away from the hand.
Patients with skier’s thumb often develop swelling, bruising, pain, and weakness near the thumb base shortly after injury. Gripping and pinching may become difficult or painful, and some patients notice a sense of instability in the thumb.
Partial ligament injuries may sometimes heal with bracing and immobilization. More significant tears may require surgical repair to restore thumb stability and function, particularly in active patients or athletes.
Base of the Thumb Pain After Trauma = Bennett Fracture
A Bennett fracture is a fracture-dislocation involving the base of the thumb metacarpal near the thumb CMC joint. These injuries commonly occur after falls, sports injuries, punching injuries, skiing accidents, and mountain biking crashes.
Because strong tendons pull on the thumb metacarpal after the fracture occurs, Bennett fractures are often unstable and may shift out of alignment. Patients commonly experience swelling, bruising, pain at the thumb base, and difficulty gripping or pinching objects.
Some Bennett fractures can be treated with casting or splinting if alignment remains stable. However, many require surgical fixation using pins or screws to restore joint alignment and reduce the risk of long-term pain, weakness, stiffness, and post-traumatic arthritis.
When Should Thumb Pain Be Evaluated?
Persistent thumb pain should not simply be ignored, especially when symptoms interfere with grip strength, work, sports, lifting, or daily activities. Evaluation by a hand specialist may be helpful when pain persists, swelling develops, thumb motion becomes limited, or weakness and instability are present after an injury.
Early diagnosis and treatment may help reduce the risk of chronic pain, stiffness, instability, arthritis, and long-term loss of hand function.
Thumb Pain Treatment in Northern Utah
Dr. Chris English specializes in treatment of thumb injuries, thumb arthritis, tendon disorders, fractures, ligament injuries, and upper extremity conditions in Northern Utah. Patients are seen from Layton, Ogden, Bountiful, Farmington, Davis County, Weber County, Salt Lake City, and surrounding communities throughout Northern Utah.
Whether thumb pain develops gradually from overuse and arthritis or suddenly after an injury, proper evaluation can help determine the underlying cause and guide treatment options designed to restore comfort, motion, strength, and hand function.