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February 2018

By Ariel Coffey, M.S., O.T.R./L, C.H.T

Have you ever experienced pain while texting or typing?  As communication patterns are changing, our society is relying more on technology for both work and leisure as forms of connecting.  With this added physical demand, our thumbs might be paying the price.

Throbbing, aching or sharp pain are common complaints of those who have experienced an overuse pain with texting.  The two-major diagnosis associated with thumb pain are osteoarthritis or a tendon inflammation (tendonitis).  It is also possible to have an underlying osteoarthritis that can be flared up with texting and overusing an already worn joint.  Where the pain is located is important in helping to figure out the diagnosis. 

If the thumb pain is located at the base of the thumb and is localized, one might suspect osteoarthritis.  If tendonitis is suspected, the pain might be felt more along the side or top of the thumb.  Sometimes this pain may be felt even past the wrist.   Two separate tests can be performed to help self diagnose what could be the cause of the pain.  These tests are a thumb joint push test and tendon stretch test.  To perform the thumb push test, one would hold onto the painful thumb with the other hand and push the thumb into the base joint.  If this test reproduces the pain, the cause could be osteoarthritis.  The second test, for tendonitis, would be to stretch the painful area to see if pain is reproduced.  This test is performed by tucking the painful thumb under all fingers and positioning the thumb to the sky, then dropping the hand down toward the ground. If pain is reproduced along the side of the thumb, or wrist, one might suspect tendonitis. 

Treatment for both of these diagnosis includes resting the joints and tendons, positioning hands and thumbs to maximize ergonomic positions, and task breakdown including stretching.  Our bodies are meant to move yet they are not meant to perform repetitive activities.  Elongating and breaking up these repetitive patterns can help minimize wear on our bodies. 

Exercises that I recommend include stretching every 30 minutes of repetitive hand activity, including texting.  Straightening out the elbow and dropping the wrist down can provide a stretch.  If more stretch is needed, a gentle push on the thumb with the other hand can be helpful.  This can be repeated for the flexor forearm and thumb by turning the palm up and letting the fingers fall.  Again, a gentle push from the other hand placed around the thumb rotating the thumb toward the ground can be helpful.  It is important to never push into pain. 

Both tendonitis pain and a flare up of osteoarthritis can take two weeks or longer to resolve.  There are options for additional treatment if pain relief is not achieved including splinting/ orthosis wearing for rest, modalities used in occupational therapy/ hand therapy for pain and inflammation reduction, and appropriate exercises to prevent future pain episodes.  Flagstaff Bone and Joint provides holistic and collaborative care.  Our therapists communicate very closely with our physicians to provide a custom treatment plans to maximize quality of life for all our patients.