What should you know about diagnosing thumb pain?

Pain at the base of the thumb may come from a tendon, joint, ligament, nerve or an injury. The clinician will ask whether it began suddenly, follows repetitive gripping, or worsens when lifting a child, turning a key or opening a jar. They may feel for tenderness, check thumb movement and compare grip or pinch strength. De Quervain's tenosynovitis is one possible explanation when pain is along the thumb side of the wrist and is aggravated by thumb or wrist movement, but examination is needed because several problems can feel similar.

Note the exact painful area, activities that trigger it, swelling or clicking, numbness, and any fall or impact. Avoid repeatedly testing a painful movement before assessment. Bring details of work, sport and hand use, plus medicines or previous hand problems. A clinician may decide that imaging is useful after the examination, particularly when an injury or joint problem is suspected.

Seek urgent assessment after a major injury, visible deformity, a cold or pale thumb, loss of sensation, or inability to move or grip. Rapidly increasing redness, warmth, swelling or fever also needs prompt review. Persistent pain that interferes with sleep or daily hand use deserves a scheduled assessment.

Ask what structure seems to be causing the pain, whether De Quervain's tenosynovitis fits the pattern, and whether imaging is needed. Discuss which activities to modify and what symptoms should prompt an earlier review.