The role of hands is self-evident. Basically, we cannot do anything without our hands. Because the frequency of using fingers is relatively high, this part is also prone to problems. Pain under the thumb on the inside of the palm may be caused by tendon sheath inflammation.

Causes of pain under the thumb on the inside of the palm

The most common clinical cause of pain under the thumb on the inside of the palm is tendon sheath inflammation at the root of the thumb. The main reason is that the thumb or one hand performs manual or fine activities for a long time, leading to inflammation of the flexor tendon sheath of the thumb and subsequent pain. The main manifestations are local stabbing pain and occasional radiating pain. Pressing with hands can induce severe pain, and sometimes trigger finger may occur.

Treatment methods for pain under the thumb on the inside of the palm

1. Closed treatment can alleviate early tendon sheath inflammation, with one closure per week. Generally, closed treatment methods have greater harm to local tissues and are prone to recurrence. Severe patients can choose surgical treatment, and should perform flexion and extension finger activities early after surgery to prevent tendon adhesion. Manual labor should be avoided within 1 month after surgery.

2. Surgical treatment: After surgery, appropriate splints are selected for fixation. In case of ineffective non-surgical treatment, small needle knife lysis or tendon sheath incision can be performed. An incision is made at the palmar transverse striae, and the tendon sheath is reached by separating with a vascular clamp to avoid damaging the digital vascular nerve bundle.

3. Puncture treatment: After local anesthesia, a thicker needle is used for puncture, and the cyst fluid is extracted and injected, followed by compression bandaging. Hormonal drugs may have side effects on the body. For cases with short duration and mild symptoms, conservative treatment can be implemented, including the use of braces to appropriately immobilize the thumb, changing the way and habits of activities that induce the disease, reducing cold stimulation, local hot compresses, physical therapy, and topical medication.

4. Acupuncture therapy: Take Yangxi, Yangchi, Hegu, Quchi, Yangque, Shousanli, Lieque, Pianli, and Ashi points on the affected side of the patient. Routine skin disinfection is performed, and Ashi points are selected as pressure points for acupuncture with the surrounding needle insertion method. After needle insertion, the method of balanced reinforcement and reduction is applied. Acupuncture and moxibustion are applied to Yangxi, Lieque, and Yangchi points once a day.

5. Massage therapy: Use massage techniques to perform dot, press, push, knead, roll, pluck, and rub on local and distal acupoints. The doctor uses the thumb to focus on kneading the radial styloid process and its upper and lower areas for 15 minutes. Treatment with the above method has achieved satisfactory clinical observation results.

Common acupoints and areas:

(1) Stenosing tenosynovitis of the radial styloid process: Quchi, Shousanli, Lieque, Hegu, and radial styloid process.

(2) Flexor tendon tenosynovitis: Neiguan, Waiguan, Ashi point.

(3) Lateral extensor carpi tendonitis: Shousanli, Waiguan, Neiguan, and radial side of the forearm extensor.

Common techniques include rolling, pressing and kneading, twisting, wiping, rubbing, hot compress, and passive joint mobilization.