Numb Thumb or numbness in thumb is one of the common reasons of people visiting the neurologist. It is characterised by decreased sensation or abnormal sensation in the thumb or the tip of thumb because of altered sensory nerve functions.

People who have a numb thumb also observe a tingling sensation in the thumb. It could be due to the decreased blood supply to the hands or damage to the sensory nerves. People working with continuously using hands or fingers tend to experience this, e.g. people doing typing for long hours, knitting, playing games etc. (1)

Causes of Numb Thumb:

There are various causes of a numb thumb. Some of the significant numb thumb causes include:

Carpel Tunnel Syndrome:

The area in your wrist where the nerves enter is called Carpal tunnel.  Carpel Tunnel syndrome is often characterised by thumbs and fingers of the people going numb. In this, the nerves of the hands and fingers are compressed and cause tingling sensation to the person.

Carpal tunnel syndrome is found to occur when the people are working with heavy tools which create vibration. This is more common in women compared to men and is found in the age group of 30-60. Some of the other causes of Carpal syndrome include

• Alcohol consumption
• Fracture or arthritis of the wrist
• Cyst or a tumour in the wrist
• Infections
• Obesity
• Rheumatoid arthritis
• Deposits of protein in the body

Arthritis history:

A person who has had arthritis in the past can cause the median nerves to get compressed and can lead to tingling sensation or thumb going numb. In many cases, thumb joint becomes swollen which further suppresses the median nerves and causes numbness.

Double Crush:

Sometimes numb thumb is caused when two different nerves are compressed in two different areas of the body. The area could be neck, arm, hands or wrist. Two of the various nerves compressed in the body would result in double crush leading to thumb going numb.

Other Causes of numb thumb:

• Peripheral Neuropathy
• Ulnar nerve compression
• Paraneoplastic Syndromes
• Guillain-Barre Syndrome: This is an autoimmune disorder in which the body’s immune system damages its nerves leading to a feeling of thumb going numb.
• Lyme disease: This occurs due to Tick bite in coastal areas. If left untreated, this leads to joint pains and numbness in hands
• Ganglion Cyst: Cysts are very common to get formed on any part of the body. In case the cysts develop near the wrists, it can lead to numbness in the hands or the thumb
• Multiple sclerosis: It is a disease of the immune system which attacks the fats around the nerve fibres of the brain and spinal cord  which can result in numbness of hands
• HIV/AIDS
• Type 2 diabetes: Type 2 diabetes can result in damage to the nerves which can, in turn, cause numb thumb or numbness in hands
• Spinal cord injury
• Deficiency in B12
• Syphilis
• Raynaud’s disease: It is a condition in which some areas of the body like the hands, fingers or toes are susceptible to cold temperature or emotional stress. During the cold attack, the blood vessels become tight resulting in constricted blood flow to the skin which results in numbness of hands and numb thumb
• Cervical spondylosis
• Vasculitis
• Use of Alcohol: A person who drinks a lot of alcohol, can lead to nerve damage causing numb thumb
• Side effects of certain drugs such as chemotherapy drugs
• Trauma and compression along median, ulnar and radial nerves may also cause numbness, weakness and tingling sensation in the hands (2)
• Compression of the single digital nerve is rare but also found to be one of the causes of numbness (3)

Symptoms of numb thumb:

Certain symptoms including numb thumb are regarded as medical emergencies. Some of the other symptoms associated with it include:

• Confusion
• Difficulty in breathing
• Dizziness
• numbness in fingers or thumb
• A headache
• Slurred speech
• Weakness or Paralyses
• The problem in gripping of things

Diagnosis of numb thumb:

Diagnosis includes various levels of examination by the doctor:

Medical History:

An Initial review of the numbness starts with knowing the medical history of the person. Also examining the arms, hands and fingers. The doctor may also advise visiting an orthopaedic or a neurologist to see if there are any nerve issues.

Diagnosis also involves MRI and imaging techniques:

MRI can help the doctor detect any displacement of bones in the neck, arms, hands, wrists and fingers which can further lead to suppression of the nerves causing numbness.

Electromyography (EMG) or Nerve Conduction Study (NCV):

EMG includes the use of needles to the affected muscles while NCV include the use of electrodes along with a small current

CT scan or Brain MRI:

In case the numbness is due to Multiple sclerosis, brain stroke or a brain tumour, in such instances brain MRI is recommended.

Lumbar puncture:

This test is recommended in case a person is expected to be suffering from Guillain-Barre syndrome. It is characterised by muscle weakness.

Blood Test is also recommended by the doctor to check if there are any Symptoms of Rheumatoid Arthritis or vitamin B12 deficiency.

Treatment of numb thumb:

There are lots of home remedies that a person can try to restore numb thumb or reduce the effect of numbness. Some of the useful home remedies include:

• Massaging: Massaging of thumb and hands can help in lowering numbness. Especially if warm water is used for massaging, it helps to increase the flow of blood to the hands and assists in providing relief to the affected part
• Exercise: Some of the exercises can also help to reduce the numbness, swelling and pain
• Stretching out the fingers wide for 10 seconds can help to reduce the pain
• Moving the hands clockwise and then anticlockwise 1- times each can also help to reduce tension in the hands and can enhance mobility
• Rolling the shoulders backwards five times and forward five times, this also helps in keeping the body relaxed (4)
• Elevate the hands: Elevating the hands and doing exercise on a regular basis helps to restore the flow of blood to the entire body
• Avoid drinking and eating specific food items: Certain food ingredients tend to worsen the numbness in the hands. These food items include dairy products, citrus fruits and wheat. One should eat food items that are rich in potassium and calcium. These involve the inclusion of banana and green leafy vegetables in the diet.
• Avoid severe cold conditions: A person suffering from the numb thumb or likely to suffer from numbness should avoid extremely cold temperatures or wear adequate clothes to prevent it.
• One should use hot and cold packs to bring sensation from numbness and bring relief to the hands.
• Drinking alcohol and smoking should be prohibited as they tend to aggravate the numbness and other conditions related to it.
• In case the numbness of hands is related to stress, then the person should try meditation and other relaxation techniques to avoid stress.

In case the home remedies are not providing relief, then the person should visit a doctor. Some of the medications that are used to treat Numb Thumb include:

Chronic Diseases:

Medications are given to ease out the symptoms of numb thumb which includes anti-inflammatory medicines which help to reduce the swelling in the hands and thumb

Complicated cases:

If the numbness or swelling is not getting cured by the use of anti-inflammatory drugs, then the person is prescribed for anti-depressants. But the dosage of antidepressants is kept less as compared to the dosage when they are used for anxiety or as mood stabilisers. The effect of these drugs to cure numbness should also be carefully monitored from time to time.

Severs cases:

If the pain is not getting reduced doctors may prescribe opioid analgesics.

There are also trials going to regenerate the damaged nerves using newer technologies and medications.

Numb thumb prevention:

There are also numerous ways that can help prevent numbness: The repetitive use of hands and fingers during work can result in damage to the nerves and cause numbness. The various methods that can be used to avoid numbness are:

• One should maintain a good posture while working on a laptop or a keyboard to ensure that the muscles and the nerves are not stretched much, and the potential injury can be avoided.
• Taking a break from your activity every 30-60 minutes. One should take a break from work on a regular basis to prevent overstretching of muscles.
• Stretching the muscles: one should do small exercises to reduce tension in the muscles
• Ergonomic chairs and devices: One can also use ergonometric designed chair and wrist devices then it can help to maintain the right postures for the back, hand, elbows and legs. One should try to have a right angle procedure between the shoulders and arms, legs and back, similarly between knees and lower part of legs.(5)

References:

1. https://www.enkiverywell.com/numb-thumb.html
2. https://www.ncbi.nlm.nih.gov/pubmed/7810463
3. https://www.ncbi.nlm.nih.gov/pubmed/15071968
4. https://www.healthline.com/health/finger-numbness#treatment
5. https://www.livestrong.com/article/16097-treatments-numbness-hands/

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