Thumb fatigue refers to muscular or tendinous overuse symptoms affecting the thumb, commonly seen in people who perform repetitive fine motor tasks or use handheld devices excessively.

• Overuse of thumb muscles and tendons:
  • Excessive texting (texting thumb)
  • Gaming or prolonged smartphone use
  • Manual tasks (sewing, writing, surgery, instruments)
  • Playing instruments (e.g., guitar, piano)

• Repetitive strain leads to microtrauma
• Fatigue of thenar muscles (especially abductor pollicis brevis, opponens pollicis)
• May be associated with early tendinopathy (e.g., De Quervain’s tenosynovitis)

• Dull ache or heaviness in the base of the thumb
• Discomfort with opposition, pinching, or gripping
• Local tenderness over thenar eminence or radial styloid
• Reduced endurance during repetitive tasks

• De Quervain’s tenosynovitis
• CMC joint osteoarthritis
• Carpal tunnel syndrome (if median nerve is involved)
• Trigger thumb

• Clinical evaluation
• Finkelstein’s test (to rule out De Quervain’s)
• Imaging (rarely needed unless persistent or severe)

• Ergonomic tool design
• Limit smartphone usage
• Adequate rest periods during repetitive work

• Excellent with activity modification and rehab
• May become chronic if underlying cause persists

• De Quervain’s tenosynovitis
• Thumb CMC arthritis
• Ergonomics in hand use