by Eric Winder, D.C.  

Weak, painful thumbs can cause a serious cramp in your lifestyle. Opening jars, writing, driving a car and other simple tasks can become difficult or painful. 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 because we depend 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 stiffening or restriction here can also be a source of pain when gripping or pulling 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 an individual. But one pattern that is common connects thumb pain to the fascia of the pectoral muscles in the chest. Time after time, I find that people with pain or arthritis at the base of their thumbs have chronic tension and restriction of the fascia (fibrous connective tissue) that covers these muscles. However, properly and thoroughly releasing restrictions can help to dramatically improve thumb pain and grip strength. 

Anyone with thumb pain has their own set of restrictions, but the restrictions of the fascia of chest muscles, wrist, forearm and thumb itself are the most typical problems. With fascia release therapy, I have seen patient after patient regain the ability to use their thumbs for normal daily activities in all but the most severe cases of thumb pain or arthritis. 

While the 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 many months and affected both 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 had the typical 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 against resistance. Her posture gave an immediate clue to the problem. When the pectoral fascia is tight, it pulls the shoulder blades forward, creating a rounded or slumped shoulder appearance. Marjorie’s shoulders were visibly rounded and forward. 

I confirmed this 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 restriction of the fascia at the front of the chest? The answer lies in how fascia works in the body. One of its most important functions is to give us position sense, or proprioception, which helps us to know where all the parts of our body are located in physical space.  

The nerve endings in fascia that give us this sensation can deliver confused input in areas where the fascia is abnormally restricted. This can cause muscle weakness or tightness in nearby or at 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, in turn, probably makes the thumb joint less stable and more prone to developing arthritis. 

The thumb pain was not Marjorie’s chief complaint. She had actually come to my office for treatment of lower back and foot pain but mentioned the difficulties with her thumbs as a side note. Over the course of several treatments, I made sure that we treated the problems which caused tension in the pectoral fascia, while also treating the areas of fascia restriction related to her other complaints. 

She experienced noticeable improvement in her thumb pain with just two treatments, and by her fifth treatment, her thumb pain was 90% better. When treating thumb pain and arthritis, the amount of improvement will vary from person to person. However, even when there is advanced joint arthritis, there can still be significant improvement in the pain. This is because strength restoration through proper treatment can better stabilize the joint. A more stable joint will become less painful, even when there is arthritis. 

Thumb problems caused by restricted fascia do not happen immediately. Over time, shoulder muscle imbalances develop as well, as a result of the restrictions, and these also need to be addressed. My patients learn to perform specific stretches for certain tight muscles and strengthening exercises for other muscles that have weakened. If done properly, these stretches and exercises make an enormous difference in how thorough and lasting the improvement will be after fascia therapy has been completed. 

When treating many types of pain in the body, the fascia connections can be quite complicated. However, in the case of thumb pain, the majority of 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 strength and function to their aching thumbs. 

Eric Winder D.C. uses gentle manual therapy and rehab techniques, without forceful manipulation, 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.