Thumb Fatigue [Neurosurgery Wiki]

This page is read only. You can view the source, but not change it. Ask your administrator if you think this is wrong.
====== Thumb Fatigue ======

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.

===== Etiology =====
  * 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)

===== Pathophysiology =====
  * 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)

===== Clinical Presentation =====
  * 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

===== Differential Diagnosis =====
  * [[De Quervain’s tenosynovitis]]
  * [[CMC joint osteoarthritis]]
  * [[Carpal tunnel syndrome]] (if median nerve is involved)
  * Trigger thumb

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

===== Management =====

^ Strategy ^ Description ^ Notes ^
| Activity modification | Reduce repetitive use | Ergonomic adjustments recommended |
| Rest and stretching | Frequent breaks and thumb stretches | Helps reduce overuse |
| Ice and NSAIDs | For pain and inflammation | Short-term use |
| Thumb spica splint | Immobilizes CMC/MCP joints | If symptomatic during tasks |
| Rehabilitation | Strengthening and endurance training of thenar muscles | With occupational/physical therapy |

===== Prevention =====
  * Ergonomic tool design
  * Limit smartphone usage
  * Adequate rest periods during repetitive work

===== Prognosis =====
  * Excellent with activity modification and rehab
  * May become chronic if underlying cause persists

===== See also =====
  * [[De Quervain’s tenosynovitis]]
  * [[Thumb CMC arthritis]]
  * [[Ergonomics in hand use]]