Thumb pain: described as any pain from the base of your thumb (knuckle) to the tip of your thumb. To establish where exactly your thumb pain is coming from it can be very helpful identifying what structure is causing your pain. Thumb pain is our field of speciality, we are the experts.

Any pain or problem in your thumb will have a ripple effect on the rest of your handwrist and elbow. So if you are uncertain what the cause may be, rather let us have a look at it before you create even more problems. Thumb pain can be caused by any of the muscles, joints, tendons or nerves in your thumb. Let’s look at each of these structures:

Thumb Pain

Why is your thumb pain lasting longer than it should?

Does this sound like you?

If any of these have happened to you – we would love to help you. The fact that you’ve tried any or all of these things already is actually a good thing, because when you know what doesn’t work – you are closer to finding the thing that does!

We invite you to come and see us. Why? Because we do things differently. We’ll do a thorough assessment and test all the possible causes. After we’ve diagnosed your problem, and explained what it’s going to need to heal, we’ll make sure you understand why this is happening.

What you can do to get rid of your thumb pain quickly?

Decide to get help

So many people rest for weeks, hoping that the pain will ‘just go away with time’, but 6 weeks down the line they’re still putting up with it, and nothing’s changed… Or the pain & swelling gets even worse. You may even cause other problems. Lack of treatment could end up costing you more time & money the longer you wait.

Do the right exercises

One of the best things to help ease your thumb pain is to do the right series of progressed exercises – as advised by a Hand expert. The right kind of activities can reduce your pain, and help your healing. Above all, exercises ensure that problems don’t come back. However, the wrong kind of exercises have the potential to increase the pain in your thumb even more.

Get hands-on treatment

Hand therapy is proven to improve pain & accelerate healing of people suffering from thumb pain. Thumb pain could be affecting your physical performance in a professional or private capacity, you may not even notice. It could even threaten your work or get in the way of spending quality time with your family & friends. Annoying thumb pain can leave you frustrated, irritated & miserable. We can enable you to live the life you desire as quickly as possible.

If you’re looking for solid advice on how to start solving your problem, you might not know if our treatment is the right thing for you, we encourage you to give us a call. This is an opportunity to get an expert’s advice about your situation. Our goal is to help you make the right decision about what to do next.

Get rid of your thumb pain in the next few days!

Muscle pain

On the palm side of the hand there are three muscles that move the thumb, situated at the base of the thumb. These muscles are the Adductor pollicis, Abductor pollicis brevis and the Opponens pollicis. The adductor pollicis pulls the thumb inwards, the abductor pollicis brevis moves the thumb away from the hand and the opponens pollicis brings the thumb around towards the palm of the hand to touch the opposite fingers hens the name ‘opponens’.

On the back of the hand there is one muscle called the first dorsal interosseous muscle that assists the adductor pollicis to close the thumb towards the side of the hand. The bulky muscle that you can palpate in the first web space.

Tendon pain

On the palm side of the thumb there is a group of rope-like tendons that run from the forearm to the tip of your thumb. The Flexor Pollicis Longus and Flexor Pollicis Brevis that gives you the ability to bend the two joints of your thumb down.

On the back of the thumb there are two tendons called the Extensor Pollicis Brevis and Extensor Pollicis Longus that allows you to straighten your thumb. If you injure these tendons you will be unable to straighten your thumb to make the OK/sharp sign.

The Flexor group on the palm side of the thumb is more prone to injury. You can cut these tendons by either glass or a knife. Defending yourself against an incoming knife by shielding yourself with an open hand may lead to a severed flexor tendon group. Another scenario may be washing dishes and the glass breaks in your hand, or even trying to catch a falling sharp object.

Trigger finger (also known as trigger thumb) is a common phenomenon that involves the flexor tendon running in the thumb. A trigger thumb leaves the thumb stuck in a bent position.

Nerve pain

Two branches of nerves give feeling and movement to the thumb. The median nerve supplies the palm side of the thumb. Similarly the radial nerve gives feeling to the top side of the thumb.

In most cases nerve compression, irritation or injury is closer to the wrist, but you will feel the dominant pain, burning, shocks, cramps, tingling, pins & needles or any other nerve pain in your fingertips and tip of the thumb.

There is a web of nerves that spreads out over your thumb to give your skin feeling. These digital nerves are almost always involved when severing a tendon, which cuts off the sensation to the skin after the laceration.

Joint pain

The thumb has three joints. First (at the base of the thumb) is the Carpometacarpal joint (CMCJ), then it is the Metacarpal phalangeal joint (MCPJ). The tip of the thumb bends at the Interphalangeal joint (IPJ).

The first joints affected by Osteoarthritis is the base of the thumb. Associated pain on movement of the thumb as well as pain when lifting or carrying objects is common. We regularly see that patients feel constant pain especially in the CMCJ when osteoarthritis has set in

Thumb Pain

Ligament Injuries

Volar Plate is a ligament that prevents your thumb from hyperextending. Trying to catch a ball but the ball overextends your fingers, may rupture these sensitive yet vital ligaments.

Ulnar Collateral ligaments are ligaments on the insides of your thumb that prevents your thumb dislocating towards the outside. Radial Collateral ligaments are on the outside of your thumb that prevent the thumb deviating towards inside. These ligaments are at the MCP and IP joints.

The thumb joints are more vulnerable to dislocate. Any overload and force to the thumb may dislocate the other joints in any direction. During a dislocation it is important to note that torn ligaments are very likely. These ligaments are responsible to keep the MPJ and IPJ stable. If an injury occurs to these ligaments, the risk of you dislocating your thumb again is very high.

Game keepers thumb is a condition when the first knuckle of the thumb hyperextends to push the joint forward leaving the thumb in a over extended position.

Ligaments are mainly responsible to keep the joint stable. In conditions like arthritis the joint surfaces are destroyed to the point where the joints normal alignment may deviate to any side, causing excessive stress on the surrounding ligaments.

Thumb fracture

Ever hit your thumb with a hammer, or closed a cupboard on it, well this is how many of our patients fracture the tip of their thumb.

The bones in your fingers have the name “phalanges”. Each thumb has two phalanges. The bones in your thumb starting from the tip is the Distal Phalanx and next is your Proximal phalanx. The proximal phalanx connects your thumb to your hand.

Thumb fractures involve the crack or splinter of any of these two bones. You may not always be sure if you have broken your thumb or not. If a fracture occured and you try to bend the thumb it will be painful but you’ll still be able to move it. Don’t fool yourself. There might still be movement in your thumb, this does not mean that you have not broken your thumb. Swelling and bruising (bleeding) may be a better guide to the severity.

When an egg is in an upright position it is able to hold a much greater weight than when you turn it onto its side. In the same way, when you apply a force to your thumb at the wrong angle, it can be very fragile to break.

Thumb pain in the …

  • Flexor Digitorum Superficial tendon avultion
  • Fractured finger
  • Flexor tendon rupture
  • Nerve pain in your fingers
  • Volar plate sprain
  • Torn Pulley
  • Flexor Digitorum Superficial tendon avultion
  • Fractured finger
  • Flexor tendon rupture
  • Nerve pain in your fingers
  • Volar plate sprain
  • Torn Pulley
  • Flexor Digitorum Superficial tendon avultion
  • Fractured finger
  • Flexor tendon rupture
  • Nerve pain in your fingers
  • Volar plate sprain
  • Torn Pulley
  • Flexor Digitorum Superficial tendon avultion
  • Fractured finger
  • Flexor tendon rupture
  • Nerve pain in your fingers
  • Volar plate sprain
  • Torn Pulley
  • Flexor Digitorum Superficial tendon avultion
  • Fractured finger
  • Flexor tendon rupture
  • Nerve pain in your fingers
  • Volar plate sprain
  • Torn Pulley

What causes my thumb pain

To understand where your thumb pain is coming from, you’d have to determine how you injured it, or if you can remember when it started. Some are outright obvious like when you slam the door onto your thumb, meanwhile others are subtle and creeps up on you – getting worse day by day. So, it’s easier to establish how your pain started and changed until now. Changes in your thumb pain gives us many clues to understand where your pain is coming from.

Our body consists of various types of tissue, some elastic like tendons, or strong like cables (ligaments), some tissue can generate movement & force like muscles. We rely on your thumb ligaments to keep joints stable, tendons to coordinate movements, and muscles to generate power to grip. The structures in your thumb are quite vulnerable to injury, especially trauma. There are more than 38 structures in your thumb that can get injured, some problems are more common than others, but just to be safe – we test them all.

Here’s a breakdown of a few structures that can get injured that gives you different types of thumb pain:

Get to the root of your thumb pain

Different structures, cause different types of thumb pain, although these are not concrete it’s a good guideline to which structure produces what type of pain

Muscle — Dull ache or stiffness, sharp pain with contraction
Nerve — Numbness, tingling, weakness, electrical stabbing feeling
Tendon — Burning pain with certain specific movements, pain comes & goes
Ligament — Pain at the end of range, unstable, clicking
Bone — Constant pain, sharp pain with certain movements
Joints — Cramp, constant stiff feeling, worse after rest, better with movement
Cartilage — Sharp pain when at certain point, painful arch of movement
Arteries — Pins & Needles, dead leg feeling, heavy feeling
Fat pad — Pinching pain, pressure increases or decreases pain immediately
Bursa — Pain only comes on after being active, better with rest
Referral from other joints — Difficult to pinpoint pain, vague painful area

Types of thumb pain and the structures they may relate to:

Nerve pain in thumb

  • Burning pain

  • Pins & Needles

  • Tingling

  • Sharp stabbing, shooting pain

  • Electrical shock pain

  • Numbness

  • Unable to control movement

  • Dead feeling over skin

Muscle pain in thumb

  • Pain gets worse during activity

  • Burning or cramp like pain

  • Stiffness and tightness

  • Dull pain when stretched

  • Pain only at the end of range

  • No loss of muscle strength

  • Able to move your thumb through the full range of movement

  • Little swelling

Joint pain in thumb

  • Sharp sudden pain

  • Worse when moving as compared to static positions

  • Pain when doing a specific moment

  • Muscle tightness surrounding sharp pain

  • Deep pulling feeling when stretched/ moved

  • With or without swelling

  • Pinching feeling at end of range

  • Unable to pinpoint it to one specific spot

  • Dull ache over a large area

  • Unable to find a pain-free position

Our experience

Our medical professionals treat all types of thumb pain – from muscles, tendons, nerves and joints. Basically we test and diagnose your problem, then treat it with a variety of techniques, machines or splints.

About our Therapists

Elmarie van der Merwe is a registered under the Health Professionals Council of South Africa as a Hand therapists and an approved hand therapy service provider to all major medical aids.

Symptoms of thumb pain

How bad is my thumb pain, really?

Size – The larger the area of your thumb pain, is better, because tendons in your hand stretch from your thumb tip to your elbow. Pain tends to radiate along the tendons and affect large areas. Tendons heal easier & recover faster.

Colour – Bruising in & around your thumb are quite common after a crack, splinter or fracture, because of the high concentration of small blood vessels in your hands. These capillaries rupture & leak plasma that pools in your thumb. Clearly something is wrong. Blue discoloration closer to your knuckles is more concerning for it involves your possible injury to the small bones in your hand & thumb.

Swelling – Swelling is your body’s way of healing itself by sending cells to heal the tissue. More swelling could mean more tissue damage, however not all hand injuries swell. Injury to tissue that develops over a few weeks doesn’t swell, because the tissue trauma is continuous and repetitive, so your body stops the inflammatory reaction. A new injury on an old problem is also possible.

Area – Thumb pain on the palm’s side are more restrictive when you grip & hold things, while pain at the back of your thumb limits you from typing or texting. If your thumb pain renders you unable to make a fist you must be more concerned. Sharp pain over a small area makes it easier to pinpoint structures near your pain. Vague, dull & deep thumb pain can take longer to identify the root cause. Compensatory patterns develop, sometimes it takes a while to just get rid of those.

Motion & sore thumb

Stiff – Thumb stiffness followed by pain is regressing and getting worse. Seek help. However, pain followed by stiffness is a good sign of tissue healing, specifically scar tissue formation. Scar tissue is hardening wound tissue that tends to shorten and pull on structures surrounding the injured site. This is more pronounced in muscle strains & tears, where the normal slide of muscles is restricted during a contraction.


Range of movement – Difficult moving your thumb through its range is a big problem. A painful arch means the structure injured only takes tension over that specific range i.e Only painful when you straighten your thumb the last 10 degrees. Thumb pain over a smaller range of movement is not necessarily better. This may point to connecting joint surfaces being injured like cartilage. If you feel pain only at the end of your range its less severe and easy to fix. When your thumb pain stops movement completely and its too painful to move, you should definitely come see us as soon as possible.

Changes over time

Intensity – When you grade your pain from 0 – 10. You may think it’s not that bad because it’s not that painful. On the contrary, pain intensity is not a sign of how severe your tissue injury is for example, complete ruptures of ligaments are less painful than partial tears. When fibers are stressed while it’s anchors are completely loose, there’s not much pain, but fibers that are partially torn will produce severe thumb pain. People have different pain thresholds, so be careful not to ignore your thumb injury.

Frequency – Pain that’s fleeting or intermittent, short burst of pain must not become more frequent and constant. This shows that the tissue damage is not getting any better. Pain that only lasts for a few seconds tend to heal faster, so the longer your pain lasts the faster you should get to us.

Latency – If your pain lags to come on and builds up over the day you must be very cautious. This is a sign of a relapse of your tissue pathology. It’s difficult to judge what makes it worse, because the pain only comes on a few hours after your activity, and not during. Your pain tends to be worse in the afternoons rather than in the morning.

Loading – Pushing through your thumb pain while you work is not a good idea. Putting compromised tissue under strain is dangerous. Would you tow a car with a partially torn cable? No! Because it just needs that final pull or jerk that could cause catastrophic tissue damage. Loading soft tissue without knowing what it’s able to handle is dangerous & reckless.

100% Covered by Medical Aid

Hand therapy claims directly from your medical aid.

Hand therapy claims directly from your medical aid.

No co-payments. No extras. No unexpected bills. Plain and simple payments. Pay with cash or medical aid. Your choice.

Diagnosis of thumb pain

Our experts know and understand the intricate anatomy of your thumb. There are many structures to test, and we even consider the complex biomechanics of each knuckle. We’ll accurately diagnose which structures are involved, and to what degree. This gives you a good idea what exactly is happening inside your thumb in order to establish the extent of the tissue damage.

During your evaluation, we’ll be stretching & stressing the soft tissue structures like muscles, ligaments, nerves and tendons. This way we can diagnose muscle tears, ligament sprains, tendinitis’s and nerve irritations. We’ll test different aspects like muscle strength, range of motion, flexibility and stability in order to confirm how severe your tissue damage is, which will lead us to tailor a treatment plan. Then we’ll customize the treatment to your specific needs. Therefore our specialists are the best at diagnosing thumb pain & thumb injuries.

The Process of Diagnosis

Diagnosis is a process of exclusion, not inclusion. Medical professionals are taught a process of elimination and deduction to identify the most possible diagnoses for your thumb pain. The better you can describe & elaborate on your pain, the better picture you’ll give us to understand what’s happened & what you’re feeling.

The practitioner uses their skills to eliminate diagnosis’s it’s not and zoom in on your problem. This elimination brings us to only a few possibilities to what could be causing your thumb pain. Then we test & assess all our possibilities to get to the root cause of your pain. We encourage you to be honest and open about what you’re feeling – to clarify, carry on or change our approach.


  • No ibuprofen or other forms of Anti-inflammatories in the first 48 hours after an injury

  • Do not use heat packs or soak your hands in warm water for the first 2 to 3 days after an injury

  • Don’t try to lift heavy objects or grip anything too tightly

  • Click, pull or your thumb & fingers

  • Try to stretch through the pain

  • Ignore swelling (clearly something is wrong)

  • Treat it without a proper diagnosis, you may end up causing more harm

  • Ignore the pain (it may be a sign of a deeper problem)

  • Leave it untreated & hope it’ll heal

Must Do

  • Protect it from further injury

  • Put an ice pack in a towel and place it on your wrist for up to 20 minutes every 2 to 3 hours

  • Take off any jewelry if your thumb starts swelling

  • Stop, cut down or limit activities that brings on your pain

  • Wear a splint to support your thumb, especially at night – you can get these at our reception (if you’re strapped for cash)

  • We can diagnose your problem fast & treat it

  • If you’re unsure what it might be – rather get an expert’s opinion

  • Give us a Call to set up an appointment to determine the tissue damage & how severe your problem is.

Makes it worse

  • Typing

  • Writing

  • Painting

  • Carry bags

  • Texting

  • Driving

  • Unlocking a door

  • Pushing onto it

Treatment for thumb pain

We have seen many patients with thumb pain and provide the best possible treatment for a faster recovery. Pain and stiffness after a thumb injury prevent you to grip or hold things. You might feel afraid to move, or scared you’ll damage it even more. We know that you’re anxious about the unknown, so that is why we are here to guide you and give you all the answers.

Your thumb pain treatment will be tailored according to various factors, but just to give you a broad idea, our focus of our treatments are:

  1. Determine what structures are injured in your thumb
  2. How bad is it injured?
  3. Protect it from further injury
  4. Help accelerate healing
  5. Re-evaluate to monitor progress
  6. Change and adapt as you get better

Hand therapy expert

Our experts can diagnose, test and treat any kind of thumb pain. We guide you to get rid of your pain as fast as possible. Our world class techniques & machines make sure you get the best value for your money. We will test a lot of different possibilities why you’re feeling this thumb pain in order to explain what’s going on in your body. It all depends on the results of our tests to determine what needs to be done. All our experts are hand specialists that can determine the slightest problem coming from your thumb, hand or wrist, so if you’re uncertain – we can help you.

Our experts determine multiple problems that can be involved, this means that we test everything to ensure we’re treating it the right way. This is our expertise & what we’re best at. We take on many roles to achieve your goals: Teacher, counselor, trainer, coach and engineer. As a teacher we explain the extent of tissue damage & the intricate details of your thumb pain & how it may affect other problems. As a counselor & pain expert, we’ll guide you every step of the way. As engineer we check the structural integrity of the tendons, ligaments & joints in your thumb.

Thumb Injuries

It doesn’t take much to fracture your thumb. Many patients come in with thumb pain that has been troubling them for more than a few weeks. When we take X-rays we usually find an old fracture still trying to heal. Then it’s too late to make changes if the bones has dislocated or started healing in the wrong position. Taking too long to seek medical help or delayed treatment can significantly change the time it takes to heal your thumb pain.

What our patients say

“I couldn’t text, it was so painful to use my thumb. YOLO right? Well, I’m so glad Elmarie could fix me. Just ask her to fix it.”

A Mostert

“My hand pain is 80% better after just 3 sessions. Elmarie is the best! She identifying the problem immediately “


“Broke my thumb after falling off a bike, didn’t really make much of it, but after the 3rd week of not being able to ride – I was going out of my mind. She gave me a splint & some exercises. I was amazed to see how the pain just disappeared. Brilliant work”

J Mahlangu

Thumb Pain

Thumb treatment is a process of understanding

Thumb treatment is a process of understanding

We have a whole range of hand and thumb treatments, but first we must know what we’re dealing with. An accurate diagnosis gives us a better understanding of the causes of your in pain.

Our Partner

Well Health Pro is a medical group of professionals that treat a wide range of muscle, joint, tendon & nerve problems.