[49F] With thumb pain, numbness, and tingling in hands
Patient Description
A 49-year-old female presents with sharp, throbbing, and aching pain in the thumb, which has been worsening over the past week. The pain is exacerbated by turning the thumb inward and gripping objects, particularly near the wrist. The patient also reports swelling at the base of the thumb, on the inside of the hand, closer to the wrist. Additionally, she experiences numbness and tingling in her hands and fingers, which can be relieved by shaking them. The numbness and tingling have been ongoing for a long time, with certain positions exacerbating the symptoms. The patient has noticed weakness in the thumb and hand, changes in grip strength, and difficulty holding objects. She also reports chronic pain or discomfort in the neck and shoulder, and occasional coldness in her hands or fingers, sometimes affecting just one finger or hand. The patient's medical history includes high blood pressure and hypothyroidism, managed with levothyroxine (175 mcg) and lisinopril (30 mg) daily. She quit smoking in February 2024 after smoking since the age of 18. There is a family history of heart disease. The patient has no known allergies or adverse reactions to medications and is not taking any other medications, supplements, or herbal remedies.
Show More
Arora's Assessment
What might be happening
Based on the symptoms and history you've provided, here are some possible explanations for your condition:
Thumb Pain and Swelling
- De Quervain's Tenosynovitis: This condition involves inflammation of the tendons on the thumb side of your wrist. It can cause pain and swelling at the base of the thumb and is often exacerbated by repetitive thumb or wrist movements.
- Carpal Tunnel Syndrome: This condition occurs when the median nerve is compressed as it travels through the wrist. It can cause pain, numbness, and tingling in the thumb, index, middle, and ring fingers. The pain can sometimes extend to the wrist and forearm.
Numbness and Tingling in Hands
- Peripheral Neuropathy: This condition involves damage to the peripheral nerves and can cause numbness, tingling, and weakness in the hands. It can be related to various factors, including diabetes, hypothyroidism, and prolonged use of certain medications.
- Cervical Radiculopathy: This condition occurs when a nerve in the neck is compressed or irritated, leading to pain, numbness, and tingling that can radiate down the arm and into the hand.
Neck and Shoulder Pain
- Cervical Spondylosis: This condition involves age-related wear and tear affecting the spinal disks in your neck. It can cause neck pain, stiffness, and sometimes radiating pain or numbness in the arms and hands.
- Rotator Cuff Tendinitis: This condition involves inflammation of the tendons in the shoulder, which can cause pain and weakness, especially when lifting the arm.
What you can do
Thumb Pain and Swelling
- Rest and Immobilization: Avoid activities that exacerbate the pain. Consider using a thumb splint to immobilize the thumb and wrist.
- Ice Therapy: Apply ice to the affected area for 15-20 minutes several times a day to reduce swelling and pain.
- Over-the-Counter Pain Relief: Continue taking Aleve (naproxen) as directed, but do not exceed the recommended dosage. You can also try other NSAIDs like ibuprofen.
- Consult a Doctor: See a healthcare provider for a proper diagnosis and treatment plan. They may recommend physical therapy, corticosteroid injections, or other interventions.
Numbness and Tingling in Hands
- Ergonomic Adjustments: Make sure your work environment is ergonomically friendly. Adjust your chair, keyboard, and mouse to reduce strain on your hands and wrists.
- Hand Exercises: Perform gentle hand and wrist exercises to improve circulation and reduce nerve compression.
- Consult a Doctor: A healthcare provider can evaluate your symptoms and may recommend nerve conduction studies or imaging tests to determine the cause. They may also suggest treatments like physical therapy or medications.
Neck and Shoulder Pain
- Posture Correction: Maintain good posture, especially when sitting or working at a computer. Use ergonomic chairs and take frequent breaks to stretch.
- Heat Therapy: Apply a warm compress to your neck and shoulder to relieve muscle tension and pain.
- Consult a Doctor: A healthcare provider can assess your condition and may recommend physical therapy, medications, or other treatments.
What you should look out for
Given the complexity of your symptoms, it's important to seek medical care to rule out any serious conditions. Reasons to seek care more urgently include:
- Severe or worsening pain: If the pain in your thumb, hand, neck, or shoulder becomes unbearable or significantly worsens.
- Loss of function: If you experience significant weakness or loss of function in your hand or arm.
- Changes in sensation: If you notice new or worsening numbness, tingling, or changes in the color or temperature of your hand or fingers.
- Signs of infection: If you develop redness, warmth, or fever, which could indicate an infection.
Remember, while I can provide information and suggestions, it's crucial to consult with a real healthcare professional for a formal diagnosis and appropriate treatment. You can also use MDandMe to journal your symptoms, track progress, get insights, and share longitudinal medical notes with your provider.
Show More
1
Hugs
0
Comments
Save
4 mo ago