Got any tips on dealing with a sprained thumb? for Questionland Seattle

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Got any tips on dealing with a sprained thumb?

So, I sprained my thumb cutting down a tree with a sawzall, which admittedly was really, REALLY stupid. But, my dad had borrowed my chainsaw and this dead apple tree was falling into my powerlines and just had to go.

In any case, the sawzall kicked back pretty hard and sprained my thumb pretty righteously. Been about 3 days and it's still significantly larger than the other thumb, it's a little numb, and has a pretty solid dull constant pain.

I'm starting to think maybe I should venture to see a doctor, but I'm currently lacking ye olde Health Insurance, so I've gotta carefully think through if anything that isn't gushing blood is worth dropping a couple benjamins to have an MD look at it and tell me to take advil.

Anybody got any tips on sprains? Home remedies? Is the Doctor just going to tell me to ice it and take ibuprofen? Can I give it another couple days, or should I cough up the cash to see a doc? Thanks in advance.

soundslikepuget asked in Aches, Pains & Illness 11 months ago | Report

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Russ Campbell, NWEBS

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Ouch!

So, I am guessing that you got through the whole task feeling like your hand was pretty tired and overused and the swelling and difficulty in use (pain) developed that evening after a few hours of time had passed. That is versus a sudden intense pain and you had to stop in the middle.

My best guess without seeing you is the injury is to your dominant hand (the one that was gripping the back of the saw) and the damage is to the ulnar collateral ligament of the medial carpal phalangeal (MCP) joint of your thumb (that is, the inside aspect of proximal joint of your thumb - the joint closest to the web space).

You can stretch that ligament over time of misuse (called Game Keeper's Thumb, think grabbing objects and twisting the hand so that lots of pressure is applied to the joint stretching the ligament gradually) or injure it quickly with a blow that causes sudden abduction of the thumb (Skier's Thumb, think planting a ski pole and then it being stuck so the thumb is forced laterally away from the hand).

What you may have done is kind of in-between these two. You applied great pressure as you worked over that hour or so of work, felt some discomfort but got through the task. So you have stretched that ligament forcibly tearing fibers. The sudden pain scenario (skier's) leads more to the conclusion of a tear (avulse) of the ligament from its bone attachment (insertion point) which can take a bit of bone with it and would be the more serious condition requiring surgical repair. The kicking or reciprocal motion back and forth of the handle of the saw repeatedly pulsed that force against that joint and its collateral ligament so you may have a some pretty significant tearing and may have bruised the bone also.

If surgical repair is not indicated then the basic treatment is immobilization with the thumb abducted in a splint with rest and non-use. Your doctor my send you to a hand therapist for that splint to be made or fitted (hand therapists are occupational therapists with extra training in dealing with hand injuries and post- surgical care).

For the immediate care, your idea of icing and an anti-inflammatory OTC medication is appropriate. Cold pack (ice) applied 20 minutes on and 20-30 minutes off repeated (continual ice application is counter productive) and use anti-inflammatory drugs according to label recommendations.

But this is your hand (probably your dominant hand) and really really important. If things really aren't getting better fairly quickly having it evaluated by a physician would be advised. They may want to x-ray to be rule out bone damage through avulsing of the ligament. The immobilization of the thumb in the right position for proper healing is also kind of important.

Here is a link so you can read about what I have been explaining.
http://en.wikipedia.org/wiki/Gamekeeper's_thumb

If my description does not fit your injury, I apologize - kind of hard sight unseen, so to speak, but same general advice applies to immediate treatment and seeing a doctor.

Russ Campbell, NWEBS answered in Aches, Pains & Illness 11 months ago | Report

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Ice and Aleve. Give it a week.

Mahtli69 answered in Aches, Pains & Illness 11 months ago | Report

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Geni

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If it's just pulled, not actually torn, then you can basically do the same home care that a doc would recommend. Immobilize it as much as possible - I used a wrist-thumb splint I bought at the drugstore - use ice and NSAIDs for the pain, and be wary of reinjuring it in future.

I'm a little concerned that it's still so swollen. You may actually have torn ligaments and need surgery. How much mobility does the thumb have? If you can barely move it without agony, it might be time to bite the bullet and see a doc.

I've now sprained my right thumb three times - once by catching an edger that was falling off the wall and bending it back WAY too far, once by falling backwards on it while squatting to run some network cords under a desk, and the last time, I was just picking up my backpack. :-( If you don't strengthen your hands, you can leave yourself very prone to doing it AGAIN. (It pisses me off every time, although the injury has never been as bad as the first one - I actually grayed out and got sick to my stomach that time.) I've never seen a doc for treatment, which might be part of the reason I keep reinjuring it, but mine was never still swollen three days later. Painful, yes, but not significant swelling.

Geni answered in Aches, Pains & Illness 11 months ago | Report

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Ice, vicodin, ibuprofin or some such thing, and marijuana. The ice will reduce the swelling as will the ibu. The vicodin will reduce the pain and has much sought after side effects. The weed will help you be ok with being bored since you won't be doing jack diddly with your hand in a bucket of ice water.

At least, that's what I would do and I have insurance.

If you can, get really into baseball in the meantime. It's the ultimate stoner sport and keeps your mind off of your thumb.

If it isn't better in a week bite the bullet and go to Carolyn Downs or some such place.

Also, I use my sawzall to cut down trees with soe regularity (as wella s a chain saw). You just need to use the right blade and cut in a way or at an angle that opens the cut and doesn't allow it to compress onto the blade.

Tom answered in Aches, Pains & Illness 11 months ago | Report

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