What Causes Pain In The Abductor Pollicis Brevis?

What Causes Pain In The Abductor Pollicis Brevis
Interesting information – Because of its role in opposition of the thumb, the abductor pollicis brevis is a particularly important component of muscular anatomy. The structure of the muscles and joints which surround the thumb is quite different to that of the other fingers, providing increased flexibility and allowing for a much greater degree of accuracy and precision of movement.


How do you treat adductor pollicis brevis pain?

Interesting information – The adductor pollicis is a fan-shaped muscle composed of two parts, or heads: the oblique head and the transverse head. While its primary function is to adduct or bring the thumb back towards the palm of the hand, it also provides 50% of the adduction force to the first metacarpal.

To feel the adductor pollicis muscle, spread your fingers and hold your palm flat and facing upwards. Place two fingers in the web space between your thumb and the base joint of your index finger. Move your fingers down to just above the fleshy part of your hand below your thumb. Adduct your thumb by bringing it closer to the palm and into its resting position, parallel to your fingers – the muscle contracting beneath your fingers with this movement is the adductor pollicis.

Pain in the adductor pollicis can occur due to osteoarthritis, soft-tissue trauma in the hand or excessive strain. One condition which can affect the adductor pollicis and thumb adduction is the gamekeeper’s thumb, in which the ulnar collateral ligament above the adductor pollicis is overly strained.

Why does my abductor Pollicis hurt?

De Quervain’s Tenosynovitis: Diagnosis & Treatment |Clinical Physio St Ives Thumb/Wrist Pain? It could be De Quervain’s Tenosynovitis. Last Updated on Jun 28, 2022 De Quervain’s Tenosynovitis is a painful condition which affects the thumb muscles (Abductor Pollicis Longus and extensor Pollicis Brevis). Commonly seen in females who are in the post-natal phase, it is caused by a rapid increase in load on the thumb muscles and tendons.

  1. This over-load is usually caused from repetitive feeding positions, lifting and holding of an new infant.
  2. It can also commonly occur in golfers.
  3. Symptoms will include swelling and local tenderness over the tendons.
  4. It can also be a sudden sharp feeling, which is not ideal when holding a young child! Diagnosis It is diagnosed by conducting a simple test called the Finkelstein test.

The tests involve bending your thumb across the palm of your hand and then bending your fingers over the thumb. The wrist is then bent toward your little finger. If this reproduces the same pain you experience, it is likely De Quervains syndrome. A will also conduct some tests on the joints around the thumb and wrist to exclude them as a source of the pain symptoms.

How do you heal abductor pollicis longus pain?

Treatment – Management of DeQuervain’s syndrome would depend on the severity of the condition and can include :

Electrotherapy modalities including local Ultrasound and TENS application Cold packs/heat packs Manual therapy including the myofascial release of the tendons and stretching Strength training for long-standing conditions. Thumb splinting(thumb spica), medication, and taping can be done for very painful or acute cases.

Thumb Splint for De Quervain’s Syndrome

Why is my abductor pollicis brevis swollen?

Wrist Tenosynovitis and De Quervain’s Stenosing Tenosynovitis – De Quervain’s stenosing tenosynovitis, trigger finger or thumb, and wrist common flexor tenosynovitis, often result from “primary” tenosynovitis caused by occupation- or avocation-related cumulative microtrauma.

Excessive loads or repetitive movements of a tendon through its tendon sheath can cause both chronic tenosynovitis, with inflammation, fibrosis and thickening of the sheath, and “fibrillar creep,” and microtears of the tendon, with swelling and bunching of the fibers. This impedes the smooth gliding of the tendon through its sheath and ultimately results in “catching,” “triggering,” or “locking.” Secondary causes of tenosynovitis are less common and include acute trauma, RA, systemic lupus erythematosus (SLE), scleroderma, psoriatic arthritis (PsA), infection, and gout.

Tenosynovitis is characterized by local pain, swelling, and stiffness. There is linear tenderness, swelling, and crepitus over the affected tendon sheath, and the pain is made worse by placing the tendon under tension, either by muscular contraction or by passive stretching.

De Quervain’s stenosing tenosynovitis of the abductor pollicis longus and extensor pollicis brevis results from repetitive activity, involving pinching with the thumb while moving the wrist in radial and ulnar directions, that causes frictional inflammation, thickening, and stenosis of the tendon sheath as it passes over the distal radius beneath the extensor retinaculum.

De Quervain’s tenosynovitis may also occur in association with RA, PsA, direct trauma, or pregnancy and during the postpartum period. Pain on the radial aspect of the wrist, and at the thumb base during pinch grip, grasping, and lifting, is characteristic.

  1. The affected tendon sheath is tender and often swollen 1 to 2 cm proximal to the radial styloid ( Fig.5-12 ).
  2. Finkelstein’s test is positive, and a tendon crepitus may be palpable.
  3. The diagnosis of de Quervain’s tenosynovitis is often confused with OA of the first CMC joint and with the intersection syndrome.
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The latter is caused by tenosynovitis of the extensor carpi radialis longus and brevis (the second extensor compartment) at its intersection with the abductor pollicis longus and extensor pollicis brevis tendons. It results from frequent repetitive wrist movements, particularly in athletes (rowers, canoeists, weight lifters).

How do you massage abductor pollicis brevis?

6.2 Massage with index finger – Bend your index finger and place its “middle” joint on the opponens or adductor pollicis muscle. Then slightly press both hands together and roll with your painful hand over the tender areas. What Causes Pain In The Abductor Pollicis Brevis

Calais-German, Blandine. Anatomy of Movement. Seattle: Eastland Press, 1993. Print Davies, Clair, and Davies, Amber. The Trigger Point Workbook: Your Self-Treatment Guide For Pain Relief. Oakland: New Harbinger Publications, Inc., Print Simons, David G., Lois S. Simons, and Janet G. Travell. Travell & Simons’ Myofascial Pain and Dysfunction: The Trigger Point Manual. Baltimore, MD: Williams & Wilkins, 1999. Print. Schünke, Michael., Schulte, Erik, and Schumacher, Udo. Prometheus: Lernatlas der Anatomie. Stuttgart/New York: Georg Thieme Verlag, 2007. Print

How do you test abductor pollicis brevis?

Assessment – The function can be tested by providing resistance to abduction up and away from the plane of the palm.

How do you relieve pain at the base of your thumb?

Medication – To relieve pain, your doctor might recommend:

Topical medications, such as capsaicin or diclofenac, which are applied to the skin over the joint Over-the-counter pain relievers, such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve) Prescription pain relievers, such as celecoxib (Celebrex) or tramadol (Conzip, Ultram)

Why does the area around my thumb hurt?

The thumb is involved in about 50% of all hand functions. When the thumb is painful or injured, it becomes very difficult to use the hand. During normal life, we take our thumbs for granted. When the thumb is not working properly, tasks are more difficult, and we then realize how important the thumb is.

How do you stretch abductor pollicis brevis?

Start out with exercises that target the abductor pollicis brevis muscle such as the thumb active range of motion exercise, tennis ball squeeze, finger adduction and thumb opposition. Or do the finger spring exercise by securing a large rubber band on the outside of your hand around your fingers and thumb.

What are the symptoms of a torn tendon in the thumb?

Injury to the Ulnar Collateral Ligament of the Thumb – The ulnar collateral ligament (UCL) of the thumb is a strong band of tissue running along the inside of the metacarpophalangeal (MCP) joint, which is where the thumb meets the palm. This ligament keeps your thumb stable, especially when you pinch and grasp things.

  1. A thumb UCL injury is commonly called “skier’s thumb,” because falling on the ski slopes with your hand strapped to a ski pole is a common cause of this injury.
  2. The ligament can also be injured more gradually, over time, from repetitive grasping or twisting activities.
  3. This type of chronic injury is known as “gamekeeper’s thumb” because originally, it was most commonly a work-related injury seen among Scottish gamekeepers (workers who manage wildlife and areas of land used for hunting).

The ulnar collateral ligament can tear in different ways. For example, it may be:

Pulled off its attachment at the base of the first bone (the proximal phalanx) in the thumb Pulled off the metacarpal bone, where it originates Torn through its middle, though this is less common

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Any strong force that bends the thumb backward and away from the palm of the hand can stretch or tear the ulnar collateral ligament. This most often occurs by falling onto an outstretched hand. Sprained thumbs are also common in skiers and in athletes who participate in sports that involve catching and throwing a ball, such as football, baseball, softball, and basketball.

Depending on the severity of the sprain, you may or may not experience pain at the time of the injury. You may have bruising, tenderness, and swelling around the base of your thumb, near the palm. If the ulnar collateral ligament is completely torn, the end of the ruptured ligament may cause a lump or swelling on the inside of the thumb. Your thumb joint may also feel loose or unstable. You may have difficulty grasping items between your thumb and index finger.

It is important for your doctor to evaluate even a mild thumb sprain if it does not improve quickly. Proper and prompt diagnosis and treatment of a thumb injury is necessary to avoid long-term complications, including chronic pain, instability, and arthritis.

How long does tendonitis take to heal in the thumb?

Tendonitis is when a tendon swells (becomes inflamed) after a tendon injury. It can cause joint pain, stiffness, and affect how a tendon moves. You can treat mild tendon injuries yourself and should feel better within 2 to 3 weeks.

What nerve supplies abductor pollicis brevis?

Innervation – Abductor pollicis brevis is innervated by the recurrent (thenar) branch of median nerve (root value C8 and T1).

Does tendonitis in thumb go away?

Treatment for De Quervain’s thumb and wrist pain without surgery – You may be able to recover from De Quervain’s tenosynovitis with home treatment. Changing your activity, resting the sore thumb joint, and treating thumb tendonitis with anti-inflammatory medications and heat or ice can improve the pain in a few weeks. Depending on your injury, you may need additional treatment like:

Splints: A special splint called a thumb spica splint can support your wrist and thumb so they can heal. Pain management: We use non-narcotic medications and integrative care like acupuncture to manage pain so you can heal. Find out more about orthopedic pain we treat, Steroid (cortisone) injections: Injected medications can deliver pain relief or lubrication directly to the inflamed area. Learn more about injections for joint pain,

What nerve controls thumb abduction?

Exercise 1 – • The exercise is performed as follows: 1. Stand facing a wall ( Fig.10.14 ).2. With your elbow straight, reach forward and place the palm of your hand against the wall, with your fingers toward the floor.3. Lean slightly toward the wall until you feel the tissues at your wrist stretching.4.

  • Hold this position for 30 seconds, and then relax your wrist.5.
  • Repeat this exercise until you can comfortably do 3 sets of 10 repetitions.
  • For added stretching, you can add the following variations to this exercise: 1.
  • Use your other hand to gently pull the fingers of your affected hand away from the wall ( Fig.10.15 ).2.

Use your other hand to gently pull the thumb of your affected hand away from the wall (stretches the abductor pollicis brevis muscle and fascia that is contiguous with the transverse carpal ligament) ( Fig.10.16 ).

How do you treat pain from flexor pollicis brevis?

Treatment – Activate Flexor Pollicis Brevis Muscle – Place the palm facing up and wrist in a neutral position. Bring the thumb to touch the base of the little finger and apply pressure as much as possible. Hold the pressure for a few seconds and release it.

What nerve innervates the abductor Pollicis?

Innervation – Abductor pollicis longus is innervated by the posterior interosseous nerve (C7, C8), which is a continuation of the deep branch of the radial nerve. The radial nerve is a branch of the posterior cord of the brachial plexus.

What nerve controls adductor pollicis?

Nerves – The adductor pollicis is innervated by the deep branch of the ulnar nerve (C8-T1). Understanding the pathway of the ulnar nerve is important for assessing clinical symptomatology of neuromuscular upper extremity injuries. The ulnar nerve is the terminal branch of the medial cord of the brachial plexus and it courses distally, running posterior to the medial epicondyle of the elbow at the cubital tunnel.

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Once in the forearm, it pierces the two heads of the flexor carpi ulnaris, giving off several branches to innervate two forearm muscles. It then traverses the wrist by traveling superficial to the flexor retinaculum and enters the hand via the Guyon canal. Once in the hand, it divides its superficial and deep branches.

The deep branch specifically travels between the muscles of the hypothenar eminence to the deep compartment of the palm to join the deep palmar arterial arch. In addition to the adductor pollicis, the deep branch also innervates the hypothenar muscles, the medial two lumbricals, the interossei of the hand, and the palmaris brevis.

Can you tear flexor pollicis brevis?

Interesting information – This singular muscle is composed of two distinct parts: superficial and deep. The joining of these two parts forms a tendon which attaches to the thumb. The fleshy soft tissue on the palm of the hand near the thumb is referred to as the thenar eminence.

It is formed by extensor pollicis brevis, flexor pollicis brevis, abductor pollicis brevis, and opponens pollicis. To test the strength and function of flexor pollicis brevis, sit in a chair with one hand resting on a flat surface and your palm facing up. Place your opposite hand on the fleshy section of palm at the base of your thumb and apply gentle pressure.

Flex (bend) your thumb against that pressure. You should be able to feel the movement of flexor pollicis brevis. If the muscle is functioning properly, you will overcome the resistance easily. Hand injuries are a very common occurrence and they account for a significant percentage of emergency room visits.

How do I strengthen my abductor Pollicis?

Abductor pollicis longus exercises – One exercise which strengthens the abductor pollicis longus can be done using a rubber band. Loop a medium-sized rubber band over both your thumbs. Push against the band by extending one thumb upwards and away from your palm. What Causes Pain In The Abductor Pollicis Brevis : Abductor Pollicis Longus (hand)

How long does thumb tendonitis take to heal?

Treatment – Treatment for de Quervain tenosynovitis is aimed at reducing inflammation, preserving movement in the thumb and preventing recurrence. If you start treatment early, your symptoms should improve within 4 to 6 weeks. If de Quervain tenosynovitis starts during pregnancy, symptoms are likely to end around the end of either pregnancy or breastfeeding.

How do you treat pain from flexor pollicis brevis?

Treatment – Activate Flexor Pollicis Brevis Muscle – Place the palm facing up and wrist in a neutral position. Bring the thumb to touch the base of the little finger and apply pressure as much as possible. Hold the pressure for a few seconds and release it.

How do I stretch my adductor pollicis?

STEP 2: How to Self-Release the Adductor Pollicis Trigger Point # One – Self-releasing the Adductor Pollicis is simple. Locate the muscle and place the pads of the thumb over it, while also supporting it with your other fingers on the back of the hand.

Now press into it. You may want to use two fingers to apply pressure over the muscle, using the leverage to better squeeze the trigger point. You can also use a small ball to the same effect and add pressure with your free hand. Hold for about 30 seconds and release. Stretching the Adductor Pollicis is simple.

We will be doing the opposite of its function, which is to bring the thumb closer to the fingers. Place your hand on a table with the palm facing down and hold onto the thumb with your other hand. Slowly pull the thumb away from the midline. Hold for 30 seconds and release, remembering to stretch both digits.

How do you heal extensor pollicis brevis?

Conservative Treatment – Usually, if the injury is mild, the symptoms resolve with adequate rest and icing. However, specific treatment for an extensor tendon injury varies according to the level of its severity. Nonoperative treatments are the first option and usually include:

Splinting the affected part to heal in proper alignment Anti-inflammatory medications Special exercises and hand therapy