Thumb Weakness: Possible Causes and When to Seek Help

Bilateral soft tissue swelling of the thumbs?

Hello Doctor: I have been experiencing a feeling of weakness in the joints of my left thumb at the two phalangeal joints, which occurred intermittently for about a month.
The sensation became more pronounced when I pressed on the joint area.
About one to two weeks ago, this weakness disappeared.
Recently, I have been feeling a similar weakness in the joints of both thumbs near the palm, which has lasted for about a week.
This sensation is especially noticeable when my fingers are pointing towards the palm.
Could there be a connection between these two issues? What could be the possible causes? If I seek medical attention, which specialty should I consult? Thank you very much for your response.

CH, 40~49 year old female. Ask Date: 2022/10/25

Dr. Jiang Junyi reply Neurology

Dear Ms.
CH,
You mentioned that "the joints of both thumbs near the palm feel weak and soft (not at the joints), lasting for about a week.
The weakness is particularly noticeable when the fingers are pointed towards the palm." Your symptoms may suggest the possibility of cervical radiculopathy, specifically involving the sixth cervical nerve root.
If the nerve compression is causing peripheral neuropathy, the following characteristics may be present:
1.
Pain with a burning or electric shock-like quality.
2.
Symptoms with a specific dermatomal distribution, which can be triggered by touch or pressure.
3.
Accompanied by muscle weakness and fatigue.
Evaluation of peripheral nerve issues typically involves electrophysiological studies to assist in diagnosis.

- Nerve conduction studies: Assess the conduction velocity and waveform of large fiber nerves.
- Electromyography (EMG): Evaluate muscle responses in the areas supplied by the affected nerves.
Thank you for your inquiry.
I recommend discussing further examination and treatment options with a neurologist.
Wishing you good health and peace,
Dr.
Jiang Junyi
Department of Neurology, Taoyuan Hospital

Reply Date: 2022/10/25

More Info

Thumb weakness and discomfort can be concerning symptoms, especially when they persist over time. Based on your description, it seems you have experienced intermittent weakness and soreness in your thumbs, particularly around the joints. This could be indicative of several underlying conditions, and understanding the potential causes can help guide you in seeking appropriate medical care.

One possible cause of thumb weakness is tendonitis, which is inflammation of the tendons that control thumb movement. This condition can occur due to repetitive motions, overuse, or strain, especially if you engage in activities that require gripping or pinching. Another potential cause could be arthritis, particularly osteoarthritis or rheumatoid arthritis, which can lead to joint pain, stiffness, and weakness. These conditions can affect the joints in the thumb, leading to discomfort and a feeling of weakness.

Additionally, nerve compression syndromes, such as carpal tunnel syndrome, could also be a factor. This condition occurs when the median nerve, which runs through the wrist, becomes compressed, leading to symptoms like weakness, tingling, or numbness in the thumb and fingers. If you are experiencing symptoms that radiate into your fingers or if you notice any tingling sensations, this could be a sign of nerve involvement.

The fact that you experienced soreness that has now shifted to a different area of the thumb may suggest a pattern of inflammation or strain that is moving as your activities change or as your body responds to rest or treatment. It is also worth considering if there have been any recent changes in your daily activities, such as increased use of your hands for work or hobbies, which could contribute to these symptoms.

Given the duration and nature of your symptoms, it is advisable to seek medical attention. You should consider visiting a healthcare provider who specializes in musculoskeletal disorders, such as a rheumatologist or an orthopedic specialist. They can perform a thorough examination, possibly including imaging studies like X-rays or MRIs, to assess the condition of your joints and surrounding tissues.

In the meantime, you may find relief through conservative measures such as rest, ice application, and over-the-counter anti-inflammatory medications. Splinting the thumb can also help immobilize the joint and reduce strain during activities. However, it is essential to avoid self-diagnosing and to consult with a healthcare professional for an accurate diagnosis and tailored treatment plan.

In summary, thumb weakness and discomfort can arise from various conditions, including tendonitis, arthritis, or nerve compression. The best course of action is to seek medical evaluation to determine the underlying cause and receive appropriate treatment. Early intervention can help prevent further complications and improve your hand function.

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