| What We Treat
Thumb Pain
Pain at the base of your thumb when you grip, pinch or open a jar? The thumb takes an enormous share of hand loading, and problems here have a disproportionate effect on daily function.
Overview
What’s Causing Your Thumb Pain?
The thumb provides roughly half of hand function, and the joint at its base is one of the most heavily loaded in the body — a pinch grip generates forces many times greater at the thumb base than at the fingertips. The most common causes of thumb pain are osteoarthritis at the base, tendon irritation on the thumb side of the wrist, and trigger thumb. Each has a distinct pattern.
Tap a structure, or use the buttons, to see what typically causes thumb pain.
Thumb Base Osteoarthritis
Pain at the base of the thumb where it meets the wrist, worse with pinching, turning keys and opening jars. Very common from middle age, particularly in women. Often produces a squared-off appearance at the thumb base over time.
Symptoms
What Your Physio Will Want to Know
The precise location and the aggravating tasks usually identify the cause:
Exactly Where
The base of the thumb, the thumb side of the wrist, or along the thumb itself each suggest different structures.
Pinching and Gripping
Difficulty with keys, jars, buttons and pegs is characteristic of thumb base problems.
Lifting With the Thumb Up
Pain lifting a baby, a kettle or a mug in this position is typical of de Quervain’s.
Catching or Locking
A thumb that catches or snaps as it straightens suggests trigger thumb.
Numbness
Tingling or numbness, particularly at night, points towards the carpal tunnel rather than the thumb itself.
Appearance
A squared-off or prominent thumb base suggests established osteoarthritis.
Causes & Risk Factors
What Drives It
Thumb problems reflect the extraordinary loads the joint carries relative to its size.
Cumulative Joint Load
The thumb base joint experiences forces many times the applied pinch force, which is why arthritis is so common there.
Repetitive Gripping and Pinching
Occupations and hobbies involving sustained pinch — needlework, hairdressing, trades — are well represented.
Hormonal Factors
Both thumb base arthritis and de Quervain’s are considerably more common in women, particularly around the menopause and after childbirth.
New Parenthood
Repeatedly lifting a baby under the arms loads the thumb tendons in exactly the provocative position, making de Quervain’s common in this group.
Diabetes
Associated with a higher incidence of trigger digits and tendon sheath problems generally.
How We Can Help You
Treatment & Management
Thumb problems respond well to a combination of load modification, targeted splinting and strengthening — and small changes to how you grip things often make a disproportionate difference.
What the evidence says
Splinting combined with hand exercise and joint protection education has good supporting evidence for thumb base osteoarthritis, with meaningful improvements in pain and function that compare favourably with more invasive options.
For trigger thumb, corticosteroid injection has good reported success rates, particularly in people without diabetes, and is usually the first-line treatment before surgical release is considered.
When to Seek Help
Red Flags — Don’t Ignore These
Thumb pain is usually mechanical. Seek assessment if you notice:
⚠ Seek prompt medical assessment if you notice:
- Tenderness in the hollow at the base of the thumb after a fall (possible scaphoid fracture — assess even if X-ray was clear)
- A hot, red, swollen thumb with fever or feeling generally unwell (possible infection — seek emergency care)
- Visible wasting of the fleshy pad at the base of the thumb (possible established nerve compression)
- A thumb locked in a bent position that cannot be straightened
- Sudden inability to straighten or bend the thumb after an injury (possible tendon rupture)
These symptoms can point to a cause that needs medical rather than physiotherapy assessment. Please don’t wait for a physiotherapy appointment — contact your GP, call 111, or attend A&E as appropriate.
Common Questions
Frequently Asked Questions
Why does my thumb hurt so much for such a small joint?
Because the loads are enormous relative to its size. A pinch grip generates forces at the thumb base joint many times greater than the force at your fingertips. That mechanical disadvantage is exactly why arthritis is so common there.
Will a splint help?
Often substantially, particularly for de Quervain’s and thumb base arthritis. A thumb spica splint offloads the joint and tendons and frequently gives noticeable relief within a couple of weeks. It works best alongside strengthening rather than instead of it.
I’m a new parent — why has this started?
Repeatedly lifting a baby under the arms, with the thumb extended and the wrist deviated, loads exactly the tendons involved in de Quervain’s. It’s so common in this group that it’s sometimes called mother’s wrist. Changing the lifting technique often helps considerably.
Do I have to stop using my thumb?
No — and you couldn’t really. The aim is reducing peak loads through adaptations like jar openers and thicker grips, while building strength so ordinary tasks demand proportionally less. Avoidance reduces capacity and makes things harder.
Small Joint, Big Impact
A precise diagnosis, the right splint if one would help, and practical changes that reduce the load on a heavily worked joint.
Book Your Initial AssessmentThis page is for general information only and isn’t a substitute for individual medical advice. If you’re experiencing any of the warning signs above, contact your GP or seek emergency medical care as appropriate.