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8 most common causes
Thumb numbness symptoms
Thumb numbness can have many possible causes. This may include injury to any nearby components of the arm, wrist, or hand, temporary nerve compression from arm positioning, nerve root compression in the neck or nerve compression in the wrist (carpal tunnel syndrome), or even some systemic illnesses.
However, if you have numbness or weakness, tingling on one side of the body, facial drooping, headache, vision changes, or confusion, these may be symptoms of a stroke and require emergency medical treatment.
If you have temporary nerve compression, the thumb numbness will resolve on its own. All other thumb numbness requires evaluation by a medical doctor. Splinting, physical therapy, medications, or surgery are all possible options for treating different causes of thumb numbness.
Besides the thumb numbness itself, there may be a presence of the following:
Causes of thumb numbness
As discussed prior, there are several different possible causes of thumb numbness. This may include injury, temporary nerve compression, or nerve compression of the nerve root in the neck or in the wrist with carpal tunnel syndrome. Some systemic illnesses like arthritis or diabetes can cause nerve damage and numbness. Numbness, weakness, or tingling on one side of the body also raises concern for stroke.
Various injuries that can cause thumb numbness are described in further detail below.
- Thumb Injury: This may include a penetrating injury to the thumb like a cut or wound that can damage the nerve that supplies sensation. Fracturing the bones of the thumb may also damage the nerve supply.
- Forearm trauma: Traumatic injury to the forearm can disrupt the nerves that supply the thumb, fingers, and hand. Injury to these nerves may lead to numbness, tingling, or weakness. Typically, penetrating trauma like cuts or knife wounds is more likely to damage nerves. It is also possible for an arm fracture to damage the nerves to the thumb, fingers, and hands, leading to numbness.
- Radiation: The nerves that supply sensation to the hands and fingers travel from the neck through the arm all the way down to their destination. It is possible for them to become damaged at any point along the way. Radiation for treatment of breast cancer typically targets the armpit area, and it is possible for this to damage nerves in the region. This may lead to weakness, numbness, or tingling in the arms, hands, or fingers.
The thumb may be indirectly affected by nerve compression, leading to numbness.
- Temporary compression: Sometimes, compression to the nerve in the armpit or along the elbow can cause temporary numbness, tingling, or pain in the arm, hands, or fingers. Some people refer to this as having a hand or arm that is "asleep." This is common after leaning on the elbow or laying on the arms for a long period of time and will resolve on its own in several minutes.
- Nerve root compression: The nerves that supply the sensation to the arms and hands originate from the spinal cord in the neck. The vertebrae or the intervertebral discs can compress the nerve as it exits the spinal cord, leading to neck, shoulder or arm pain, muscle weakness, numbness, or tingling. Typically, numbness, weakness or tingling will occur only on one side.
- Carpal tunnel: The nerve that supplies sensation to the thumb, pointer finger, and middle finger can be compressed leading to numbness, tingling, and pain in these three digits. This is more common among women, people who are obese and may be related to repetitive hand movements like typing. The symptoms are typically worse at night and may radiate from the thumb and fingers up through the wrist and forearm.
Other causes that may not exclusively affect the thumb may include the following.
- Stroke: Numbness, tingling, or weakness, especially on one side of the body could be symptoms of a stroke. While we typically think of facial droop and weakness on one side as classic stroke symptoms, strokes can cause any neurologic symptoms. If you suspect someone might be having a stroke, seek emergency medical treatment right away.
- Arthritis: Arthritis typically presents with swollen, tender joints in the hands as well as reduced grip strength. Some people with arthritis also complain of numbness or tingling in the hands and fingers. This disease may start with the joints of the hands but typically spreads to other joints like the wrists, elbows, and knees.
- Other systemic diseases: Some systemic diseases like vasculitis or diabetes can cause nerve damage over time. In diabetes, typically the nerve damage starts in the toes and feet but may also affect the fingers and hands. Vasculitis has the ability to damage nerves in the limbs as well. Other symptoms of uncontrolled diabetes include high blood sugar, vision damage, or kidney damage. Symptoms of vasculitis are very nonspecific and may include fever, weight loss, as well as weakness, numbness, or tingling.
This list does not constitute medical advice and may not accurately represent what you have.
Ulnar nerve entrapment of elbow
Ulnar nerve entrapment of elbow is also called cubital tunnel syndrome. The ulnar nerve begins at the spinal cord in the neck and runs down the arm into the hand. This very long nerve can become compressed, or entrapped, by other structures at certain points along the way. Entrapment often happens in the cubital tunnel, which is the narrow passage at the inside of the elbow.
The exact cause for entrapment may not be known. Fluid buildup and swelling inside the elbow; previous elbow fracture or dislocation; or leaning on the elbow for long periods of time can put pressure on the ulnar nerve inside the cubital tunnel.
Symptoms include numbness and tingling of the hand and fingers, sometimes leading to weakness and even muscle wasting in the hand.
Diagnosis is made through physical examination, x-ray, and nerve conduction studies.
Treatment begins with wearing a supportive brace and adjusting activities to avoid further irritating the nerve. Surgery is usually not needed unless the nerve compression is causing weakness and loss of use in the hand.
Top Symptoms: hand weakness, weakness in one hand, numbness in one hand, pain in one elbow, pain in one forearm
Urgency: Primary care doctor
Thoracic outlet syndrome
The "thoracic outlet" is the space on either side of the base of the neck where nerves, arteries, and veins travel beneath the collarbone. If these become compressed or damaged, the condition is called thoracic outlet syndrome or TOS.
The most common causes are trauma, such as a car accident or fall; and repetition or overuse, such as a sports injury.
Symptoms vary depending on the structures being compressed:
- Neurogenic TOS affects the nerves. It is the most common form and creates numbness, tingling, pain, and weakness in the arms, hand, and fingers.
- Vascular TOS affects the arteries and veins. It creates the same symptoms as neurogenic TOS as well as cold, pale hands and arms with weak pulse.
It is important to see a medical provider about these symptoms so that the damage does not become permanent.
Diagnosis is made through patient history, physical examination, imaging such as x-ray or ultrasound, and sometimes nerve conduction and blood flow studies.
Treatment involves physical therapy, pain relievers, and sometimes surgery.
Raynaud phenomenon, also called Secondary Raynaud syndrome, is a condition that causes small arteries in the skin to abnormally constrict on exposure to cold water or air. This limits blood flow to the hands, fingers, feet, toes, nose, and ears.
Secondary Raynaud syndrome is rare and is caused by another underlying medical condition, often a connective tissue disorder such as rheumatoid arthritis, scleroderma, or lupus.
Women are more likely than men to be affected, especially if living in cold climates. Family history and smoking are also risk factors.
Symptoms include the hands and feet becoming numb and cold. The skin color changes from pale to bluish, and then to red as the skin warms again.
If not treated, patients may get ulcerated sores or deformities of the fingers and toes, or even gangrene, due to the lack of circulation.
Diagnosis is made through patient history, physical examination, and blood tests.
Treatment includes medications to help increase circulation; treatment of any underlying conditions; and lifestyle changes to gain better protection for the extremities in cold conditions.
Pinched nerve in the neck
A pinched nerve in the neck is also called cervical radiculopathy. It means that a nerve in the neck, at a point where it branches off from the spinal cord, is being compressed by the surrounding bones, muscles, or other tissues.
It can be caused by a traumatic injury, such as from sports or an automobile accident, especially if the injury results in a herniated disk. It may also arise from the normal wear and tear of aging.
Symptoms include sharp, burning pain with numbness and tingling from the neck to the shoulder, as well as weakness and numbness into the arm and hand.
Diagnosis is made through patient history, physical examination, and simple neurological tests to check the reflexes. Imaging such as x-ray, CT scan, or MRI may be done, as well as electromyography to measure nerve impulses in the muscles.
A pinched nerve in the neck often improves with simply a few days or weeks of rest. Physical therapy, nonsteroidal anti-inflammatory drugs, and steroid injections into the spine can all be very helpful.
Top Symptoms: pain in one shoulder, spontaneous shoulder pain, pain that radiates down arm, pain in the back of the neck, severe shoulder pain
Urgency: Primary care doctor
Panic or anxiety attack(s)
Panic disorder means a generalized set of symptoms involving sudden, unexplained feelings of anxiety and overwhelming fear. The physical symptoms are very real and consist of sweating, pounding heart, and shortness of breath.
The cause is not known. It may involve changes in brain chemistry that cause a person to perceive danger where there actually is none. Severe and ongoing stress, as well as post-traumatic stress disorder (PTSD) may be factors.
Panic disorder is most common among women. It can affect anyone, however, especially with a family history.
This condition does not improve on its own. If left untreated, the patient may become isolated and even suicidal.
A doctor will do a complete workup, including blood tests, to rule out any physical causes for the symptoms. A psychological workup will also be done.
The first line of treatment is talking with a professional who can help with coping and stress management. Medication, including some antidepressants and calming drugs, may be used temporarily but can cause dependence and unpleasant side effects if used for too long.
De quervain's tenosynovitis
De Quervain's tenosynovitis is a painful condition affecting the tendons on the thumb side of the wrist. If you have de Quervain's tenosynovitis, you will feel pain upon turning your wrist, grasping anything, or making a fist.
You should visit your primary care physician to confirm the diagnosis and discuss treatment options. You can also reduce pain and swelling with over-the-counter pain relievers, such as ibuprofen (Advil, Motrin), naproxen (Aleve).
Chronic idiopathic peripheral neuropathy
Peripheral neuropathy refers to the feeling of numbness, tingling, and pins-and-needles sensation in the feet. Idiopathic means the cause is not known, and chronic means the condition is ongoing without getting better or worse.
The condition is most often found in people over age 60. Idiopathic neuropathy has no known cause.
Symptoms include uncomfortable numbness and tingling in the feet; difficulty standing or walking due to pain and lack of normal sensitivity; and weakness and cramping in the muscles of the feet and ankles.
Peripheral neuropathy can greatly interfere with quality of life, so a medical provider should be seen in order to treat the symptoms and reduce the discomfort.
Diagnosis is made through physical examination; blood tests to rule out other conditions; and neurologic and muscle studies such as electromyography.
Treatment involves over-the-counter pain relievers; prescription pain relievers to manage more severe pain; physical therapy and safety measures to compensate for loss of sensation in the feet; and therapeutic footwear to help with balance and walking.
Top Symptoms: distal numbness, muscle aches, joint stiffness, numbness on both sides of body, loss of muscle mass
Urgency: Primary care doctor
Carpal tunnel syndrome
Carpal tunnel syndrome causes numbness and pain in the underside of the wrist and hand. It is caused by narrowing of the carpal tunnel passageway, which puts pressure on the nerve running through it.
Narrowing and deformity of the tunnel is most often from overuse, especially highly repetitive activities such as typing or working on an assembly line. Wrist fracture or arthritis can damage the carpal tunnel, and so can diabetes and obesity.
Symptoms include numbness and shocklike pain in the wrist, palm, and fingers. There may be weakness in the hand when trying to hold an object.
Carpal tunnel syndrome virtually always gets worse over time. Permanent damage may result, so it is important to be seen by a medical provider.
Diagnosis is made through patient history and physical examination. X-rays or electromyography testing may be used.
Rest and cold packs to the wrist will reduce swelling. Wrist splints and ergonomically correct keyboards and other devices during work are often helpful.
Corticosteroid injections and surgery may also be tried.
Thumb numbness treatments and relief
As long as you are not experiencing severe, widespread numbness, or numbness that is persisting for several hours, treatments can begin at home. However, it is still advisable to consult your physician.
Seek emergency treatment for the following
If you experience stroke-like symptoms associated with your thumb numbness, you need to be treated immediately. Stroke symptoms include:
- Numbness or weakness
- Tingling on one side of the body
- Facial drooping
- Confusion, trouble speaking or understanding
- Severe headache
- Vision changes
Once you are in the care of a medical team, they will determine the best course of action to treat any symptoms or complications.
It is possible that temporary compression to the nerve along the arm is the cause of your thumb numbness. This should resolve on its own in several minutes, and does not require any additional treatment. If the numbness does not go away within the span of several hours, it is advisable to seek medical treatment.
Persistent numbness to the thumb indicates a nerve problem, which should be evaluated by a physician. During or after the consult, he or she may recommend the following treatments appropriate for your condition.
- Wrist splinting: Wrist splinting, particularly at night, may relieve some of the symptoms of carpal tunnel syndrome.
- Wrist surgery: This is the only definitive treatment for carpal tunnel syndrome. It involves releasing the tendon that compresses the nerve to the thumb and fingers, thereby relieving the numbness, tingling, and pain.
- Surgical repair: If you have an injury to the arm, wrist, hand, or thumb that is causing numbness in the thumb, the injury will require medical evaluation and may require surgery.
- Medication: If your physician suspects that a systemic illness like arthritis, diabetes, or vasculitis is the cause of your numbness, they will likely recommend treatment with medication. This may involve adjusting or changing your current medication regimen, or referral to a specialist who can further help manage your illness.
- Physical therapy: If your thumb numbness is due to compression of the nerve root in the neck, yourphysician may recommend physical therapy. Improving range of motion of the neck and increasing flexibility may improve symptoms.
- Neck surgery: If you have persistent symptoms from compression of the nerve root in your neck, yourphysician may recommend surgery.
Questions your doctor may ask about thumb numbness
- What is your body mass?
- Turn your head toward the side of your body that is hurting. Lift your head up as someone else pushes down on your head. Does this cause greater pain in your upper body? (This is known as Spurling's test.)
- Does the numbness affect one hand or both hands?
- Have you ever been diagnosed with diabetes?
Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.
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- Numb Hands. American Society for Surgery of the Hand. Published 2016. ASSH Link
- Lambert T. Explaining Numbness in Fingers and Thumb. Arthritis Foundation. Arthritis Foundation Link
- Ma CB. Carpal Tunnel Syndrome. U.S. National Library of Medicine: MedlinePlus. Updated April 18, 2017. MedlinePlus Link
- Signs and Symptoms of Stroke. National Stroke Association. National Stroke Organization Link
- Thumb Arthritis. American Society for Surgery of the Hand. Published 2018. ASSH Link
- Diabetic Neuropathy. National Institute of Diabetes and Digestive and Kidney Diseases. NIDDK Link
- Vasculitis. National Heart, Lung, and Blood Institute. NHLBI Link