Thumb Weakness: Causes and When to See an Orthopedist - Orthopedics

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Inability to exert force with the thumb?


Hello, my left thumb at the joint connecting to the web space has a congenital condition that allows it to hyperextend backward, but it hasn't caused any issues in my daily life.
However, about 2 to 3 weeks ago, I started experiencing frequent numbness in my left hand, and my thumb has begun to lose strength.
I can no longer press down on the nail clipper with my thumb as I normally would; instead, I have to place the nail clipper in the web space to cut my nails.
What could this condition be, and would it be appropriate to visit an orthopedic clinic? Thank you.

Ms. Chen, 20~29 year old female. Ask Date: 2016/11/24

Dr. Shi Guozheng reply Orthopedics


It could be joint inflammation or neuritis, so you might want to consult an orthopedic specialist.

Reply Date: 2016/11/24

More Info


Thumb weakness, particularly when accompanied by sensations of numbness, can be indicative of several underlying conditions. Given your description of the thumb being able to hyperextend at the joint and the recent onset of weakness and numbness, it is essential to consider both anatomical and neurological factors that could be contributing to your symptoms.

One potential cause of your thumb weakness could be related to a condition known as "De Quervain's tenosynovitis." This condition involves inflammation of the tendons that control thumb movement, leading to pain and weakness. It is often exacerbated by repetitive motions or overuse, which may not have been an issue for you until recently. The hypermobility of your thumb joint could also contribute to instability, which might lead to tendon irritation.

Another possibility is that you may be experiencing symptoms related to nerve compression, such as carpal tunnel syndrome or another form of peripheral neuropathy. The median nerve, which runs through the wrist and into the hand, can become compressed, leading to weakness, numbness, and tingling in the thumb and other fingers. This is particularly relevant if you have been engaging in activities that put strain on your wrist or if you have any underlying conditions such as diabetes or thyroid issues that could predispose you to nerve problems.

Given that your symptoms have persisted for a few weeks and are affecting your daily activities, it is advisable to seek an evaluation from an orthopedic specialist. An orthopedist can perform a thorough physical examination, assess your range of motion, and determine if there is any joint instability or nerve involvement. Diagnostic imaging, such as X-rays or an MRI, may be warranted to rule out any structural issues or to assess the condition of the tendons and nerves.

In the meantime, you might consider some conservative management strategies. Resting the affected hand, applying ice to reduce inflammation, and avoiding activities that exacerbate your symptoms can be beneficial. Additionally, over-the-counter anti-inflammatory medications may help alleviate pain and swelling. If you suspect that your symptoms are related to overuse, taking breaks and modifying your activities could also provide relief.

Physical therapy may be another option to explore once you have a diagnosis. A physical therapist can guide you through exercises to strengthen the muscles around the thumb and improve its stability. They can also provide education on proper ergonomics and techniques to avoid further strain on your hand.

In summary, while your thumb weakness and numbness could stem from various causes, it is crucial to consult with an orthopedic specialist to obtain a proper diagnosis and treatment plan. Early intervention can prevent further complications and help restore function to your thumb, allowing you to return to your daily activities without discomfort.

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