by Eric Winder, DC     

Weak, painful thumbs can cause a serious cramp in daily activities. Opening jars, driving, writing and performing other basic tasks can become difficult. Fortunately, thumb joint pain and arthritis can often be relieved by treating restrictions in the connective tissue called fascia.  

The first place to look for fascia restrictions related to thumb pain is around the thumb and wrist, as well as muscles in the forearms. Thumbs undergo wear and tear since we rely on them so heavily. In fact, the base joint of the thumb is the most common joint to develop wear and tear arthritis. The largest muscles that move the thumb are in the forearm, so fascia stiffness or restriction here can also be a source of pain when you grip or pull an object.  

In many previous articles, I have discussed how fascia restriction in one part of the body often causes pain somewhere else. The patterns of pain referral can be unusual or even unique to each person. But one common thread connects thumb pain to the fascia of the pectoral muscles in the chest. Frequently, I find those with pain or arthritis at the base of their thumbs have chronic tension and restriction of the fascia (connective tissue) that covers these muscles. 

 Correctly and thoroughly releasing these restrictions can help to dramatically improve thumb pain and grip strength.  Anyone with thumb pain will have their own unique set of fascia restrictions, but restrictions in the chest muscles, wrist, forearm and thumb itself are the most common problems. With fascia release therapy, I have seen patients regain the ability to use their thumbs for normal activities in all but the most severe cases of thumb pain or arthritis. 

While this problem affects both men and women, in my practice, I generally see more women suffering thumb pain. In fact, research shows that women have thumb arthritis 10 times more frequently than men, so this comes as no surprise. A recent patient, whom I will refer to as Marjorie, is an excellent example of this.  

While most women do not develop thumb pain or arthritis until their 40s or later, Marjorie’s problems began in her late 20s. Her pain developed gradually over the course of several months and affected both of her hands. It was reaching the point that she had to stop doing several different types of exercise that involved the use of her hands.  

On examination, she presented with sharp tenderness at the base joints of the thumbs. She felt weakness when extending or flexing her thumbs, and she could not hold her thumb and index fingers pinched together with resistance. Her posture gave an immediate clue into the problem. When the pectoral fascia is tight, it pulls the shoulder blades forward, creating a round or slumped shoulder appearance. Marjorie’s shoulders were visibly round and forward.  

I confirmed the connection to her thumb pain with a simple test. I pulled back her shoulder blade and applied finger pressure to stretch the pectoral fascia. While holding this pressure, I tested her thumb strength with my other hand. Compared to no stretch or pressure, there was an immediate improvement in thumb strength with a decrease in pain.  

How is it that thumb pain can be caused by fascia restriction at the front of the chest? This answer lies in how fascia works in the body. It gives us position sense, or proprioception, which helps us know where all the parts of our bodies are located in physical space.  

The nerve endings in fascia that create this sensation can also deliver confused input in areas where the fascia is abnormally restricted. This can cause muscle weakness or tightness in nearby or distant parts of the body. In the case of restricted pectoral fascia, there is a strong tendency to cause weakness of the thumb muscles. This weakness can make the thumb joint less stable and more prone to developing arthritis.  

The thumb pain was not Marjorie’s chief complaint. She had come to my office for treatment of lower back and foot pain, then mentioned the difficulties with her thumbs as a side note. Over the course of several treatments, we treated the problems which caused tension in the pectoral fascia, while also treating the fascia restriction related to her other complaints. She experienced noticeable improvement in her thumbs with just two treatments, and by her fifth treatment, her thumb pain was 90 percent better.  

When treating thumb pain and arthritis, the amount of improvement will vary from one person to the next. However, even in cases of advanced joint arthritis, there can still be significant improvement in the pain. When strength is restored with the correct treatment protocol, this will stabilize the joint. A stable joint is less painful, even with arthritis.  

With tight pectoral muscles, shoulder imbalances develop as well. My patients learn to perform specific stretches for these tight muscles, along with exercises to strengthen weakened muscles. If done correctly, these stretches and exercises make an enormous difference in lasting thumb pain relief after the fascia therapy is complete.  

When treating various types of pain in the body, the fascia connections can be quite complicated. However, in the case of thumb pain, most cases involve a simple connection with the fascia of the chest, thumb, wrist and forearm. Treatment is usually straightforward, and the success rate is high. There is some homework involved, but most patients find it worth the effort to restore both strength and function to their aching thumbs.    

Eric Winder, DC, uses gentle manual therapy to help patients with a wide range of pain and injury problems. For more information, call 941-957-8390 or visit Gentlebay.com. Dr. Winder’s offices are located in Sarasota and Osprey.