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Right Thumb Pain
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Right Thumb Pain

I have been having pain in my right thumb for the last 2 years. The only way I can describe it is a constant soreness.  I have been to numerous doctors including neurologists, orthopedists and hand surgeons. Tests done include 2 nerve conductions, nerve block, mri on thumb, wrist and spinal cord, x-ray on hand and a ultrasound. None of them have been able to diagnose what the problem is. Is there anything else that could be causing this pain?
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8 Comments
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324691_tn?1302555442
Arthritis, plain and simple. Gets inflamed daily and its off to the races. What do you do for a living? Carpal tunnel can start in any digit.
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Avatar_n_tn
I have done computer work for the last 10 years. I was thinking it could be something like arthritis early on but when I suggested to several of the doctors including the hand surgeon they said that it was not the problem. Is there a certain type of specialist that I have not been to that might be able to diagnose and threat this properly?  
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Avatar_f_tn
Let's see, I believe Carpal Tunnel affects all of the fingers except the pinky.  Then the ulnar nerve does the pinky, ring finger and half of the middle.  I have had Carpal Tunnel badly before from typing.  It usually radiates all the way into my wrist, though.  There is a test you can do to see if it's CT, basically holding the backs of your hands together in front of you and if your fingers go numb, that's CT.  Here's a link to a very informative and easy to follow video http://www.youtube.com/watch?v=gLYsnD3JHfA on how to do the test.
Really it could be a lot of things, arthritis being a big one, bursitis, and tendonitis.  I have all three in my shoulder, no fun at all.
I'm sorry they haven't been able to find anything.  Sometimes a skilled physical therapist can do some tests and give you a good guess as to what it may be.  I know it's very frustrating when they can't figure out what it is.  I hope you get some answers!
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Avatar_f_tn
I have terrible arthritis in lots of places, back, hip, and hands.  The worst for me were both my thumbs.  Mine started when I was young but it was tolerable.  When I went to work as a court reporter full time and had to use my hands constantly, it got out of control.  I had cortisone injections in both thumbs but probably had too many and the whole joint basically fell apart.  Then I had the joint replaced with an artificial joint which failed and had to be removed.  Since then I've had a total of 8 surgeries.  My last surgery fused the joint, and I still don't have relief from the pain.  During all this I ended up with RSD so now the pain isn't contained to just the joint.

You could have carpal tunnel syndrome. Or arthritis.  Or RSD.  Or any combination of that.  You could also have something else.  Carpal tunnel and arthritis should be fairly easy to diagnose though.

You don't say how old you are.  Is your pain getting worse?  Does it come and go or is it fairly constant?  

Any of these conditions can be extremely painful and often debilitating.  At this point, I'm considered 100 percent disabled. Never thought it could happen at 47.  

You've seen all the doctors that I would recommend.  Maybe you could try a rheumatologist.  It could be some sort of autoimmune disease.  I have a friend who's a NP in rheumatology and I often run by my treatment options and problems.

I can tell you what used to help me and things that I have now (mostly prescribed.)

I take 800 mg. ibuprofen. It helps a bit with pain and also works on inflammation.  Some people can't take ibuprofen, especially in high doses, as it hurts their stomach. You should always take it with food and of course, talk to your doctor before taking anything new, even over-the-counter medication.

Another OTC to try is glucosamine chondroiton.  People swear by this for joint pain.  It can take a few months to kick in.  For me, by the time I found out about it, it was too late for my hands, but I do find it helps other joints for me.  It can be a little pricey, but a  lot of pharmacies have a "buy one get one" sale.  Also, Costco carries it at a better price.

The ThermaCare hand wraps help me a lot!  Cold makes mine much worse (I hate winter and air conditioning!)

There are OTC creams you can rub in.  I never found them to be much help.  But I do have prescription creams that help a lot.  One is called Voltaren gel.  I found it helped a bit. (It's also expensive and some insurances won't cover it but you can get samples from your doctor.

I now have another compounding cream that is specifically made up for me and I have to get it done by a special pharmacy and they mail it to me.  It doesn't have a name.  My doctor calls in what she wants in it.  I forget what's in mine; there are several things. I do know it has ketamine, lidocaine and several other medications.

I've also used a brace on and off.  It supports the thumb and takes the pressure off a bit.  Right now I have a hard time wearing it because of the RSD.  I have a sort of soft one that I got at the doctor (or you can probably by at a pharmacy or medical supply store.)  I also had a hard one custom made by a physical therapist.

Now I'm doing things like getting stellate ganglion blocks for the RSD and hand pain.  The idea is to block the sympathetic nerve.  I've had about 5 of those.  Some I get relief for a few days and other times I get no change. But I've never had it made worse by these.

I see my pain management doctor and she has me on a ton of medication.I just started the Fentanyl patch about a month ago and I'm finding it very helpful, though I still need breakthrough medication.

Getting a diagnosis can sometimes be a very difficult, long path. My suggestion is don't give up.  Keep searching.  Remember, just because they can't find the problem YET doesn't mean there isn't one. I can remember times thinking I was crazy or a hypochondriac.  When I finally found the doctor who figured it out he said, "I have never seen anything so bad in someone your age before."  Now, that's not really something anyone wants to hear, but for me it was music to my ears.  To finally have someone acknowledge there was a real REASON for my pain.

This forum has been so helpful to me.  I wish I found it years ago!  CP can be a long and frustrating path, even with a correct diagnosis.  Getting support from others in the same place as you is so helpful.

If you have any other questions, feel free to PM me.
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Avatar_n_tn
I am male and only 35 years old. I can't really say the pain is getting worse - it is just constantly there. I feel that is only going to get worse if not dealt with now. I am already having problems doing my job. I have learned to deal with the pain because no one has been able to give me an answer. I have wasted thousands of dollars already on all of these tests and doctor appointments and the only answer has been to go see a pain management specialist or physical therapist which I have not done yet. I tried wearing a brace early on when this started and it only made things worse. I have had numerous blood tests as well checking for all sorts of things - all came back normal. Sometimes I think I am losing my mind. Especially after meeting with a hand surgeon 4 separate times. His suggestion was to take vitamin B supplements which did nothing. He basically said there was nothing he could do.
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Avatar_f_tn
Hmmm, you definitely have a dilemma!  Let me just give you a piece of advice (which of course if only MY opinion.)  Do not let anyone make you think this is in your head.  It isn't.  The plain and simple fact is that lots of things can be difficult to diagnose and lots of times it takes people years.  For many years people who suffered from chronic fatigue syndrome and fibromyalgia were written off as hypochondriacs, etc.  Just because a doctor or test doesn't reveal what's going on doesn't mean there's nothing wrong.  

It sounds like you've seen all kinds of doctors and had numerous tests.  I would think x-rays, etc. would show arthritis.  Braces doe help some people and others it does make it worse.  It helped me until I got the RSD and then I couldn't tolerate it.

Even if you don't find a diagnosis, try a pain clinic.  I get great relief from mine.  Plus, they may have some ideas since they see all kinds of different pain conditions.  (I'm not sure where you live and I'll check that in a minute.) If you didn't go to a hand specialist that's affiliated with a large teaching hospital, you may want to try a different one.  (I had seen a local guy for YEARS and in the end, he did more damage.)

Thirty-five is pretty young, but I can remember my thumbs hurting in certain situations when I was as young as 17.

I can sense your frustration, and I understand it as well.  Whatever the cause is, keep trying different things to get relief until you get to the bottom of it. The chronic pain forum on this site is a terrific place for support, even just for venting at times.

I'm wondering what type of pain you have?  Is it stabbing, burning, achy, sore, etc.?  Is there anything you can do that brings any relief at all?  Advil, Tylenol, OTC cream, etc.?

No one ever suggested Vitamin B for me and I don't know what they are supposed to help.  I do know for joint pain (and I'm not sure that's what yours is) glucosamine chondroiton is really helpful for many but it takes about 3 months to kick in.

Has anyone ever suggested a cortisone shot?  Did you ever have any kind of injury to the thumb or the hand?  Even slight?  Sometimes RSD comes from a trauma (and sometimes from nothing at all.)  A pain management doctor may help you come up with more ideas on what's going on.  RSD progresses and can often take over other parts of the body as well.  The sooner you get a diagnosis and start trying to treat it, the better off you are.  

If it's a nerve-type pain, doctors often try Lyrica or Neurontin.  Some doctors also try Cymbalta, which is an antidepressent but works on pain.  There are so many things you can try to manage pain but of course, it's easier with a diagnosis.  Going to a pain doc really may be your best bet, both at getting some relief and in finding a diagnosis.

Best of luck.  I hope you'll keep posting (as now I want to know what's going on with your thumb!!!  I empathize with you.  People don't give their hands or thumbs much thought.  But when simple tasks become difficult, you realize how very much you need them.  Driving, laundry, cooking, buttoning things are all very, very hard for me to do, even when my pain is controlled well.  I just don't have any strength in it.
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Avatar_n_tn
Thanks for the suggestions! I have not given up it is just really frustrating at times when none of these "doctors" can give you any answer. Maybe a pain clinic is what I need to try.

The pain feel like it shoots right through the nerve of my thumb and the palm feels almost like the pain from a bruise. Like if some were to punch you and it left a bruise and was really sore for a few days only it constantly feels like that. If I stretch all my fingers out then I can really feel it. It is also really sore when I try to bend the thumb or pinch anything between the thumb and index finger. There is some soreness in the wrist area as well but most of the pain is contained in the thumb and palm. I have noticed a few times while sitting on the floor when I go to push myself up using my right hand that it felt like my wrist has going to completely give out - I am not sure if that is related or not.  I do not remember injuring my hand in any way and it just came on suddenly beginning as a numbness in my entire right forearm similar to the feeling of hitting your funny bone.  Then after a couple of weeks in became focused only in the thumb and palm. That is still were it still is.

It doesn't feel like a stabbing or burning pain - more like a constant aching soreness. The thumb is very sensitive to cold as well and and gets aggravated just washed my hands when the water hits the top part of my thumb on the nerve.

I suggested a cortisone shot to the hand surgeon. He told me after the MRI showed that everything was normal that I was not a candidate for surgery or anything else and there was nothing else he could do. Basically referring me to a physical therapist.

I have been prescribed numerous medications throughout all of this including
Lyrica and Neurontin and many others pain medications. The last couple were darvocet and  oxycodone.  All they did was knock me out and leaving me barely able to function during the day - the pain was maybe masked slightly from a couple of those but still there. I stopped taking everything months ago. I have tried most of the over the counter ones you mentioned above as well. I just don't think it is something that a pill can fix.

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351246_tn?1379685732
Hi
Welcome to the MedHelp forum!
Apart from the tests you have had, you should get tests done to rule out gout and rheumatoid arthritis. Other than that it could also be reactive arthritis or even osteoarthritis.
It is difficult to comment beyond this at this stage.  Try and consult a rheumatologist. Please let me know if there is any thing else and do keep me posted. Take care!
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