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Arthritis and Rheumatism

Why does the palm of my left hand hurt?

06/27/2007

Question:

I am a 56 year old female in overall good health. I exercise regularly and am the proper weight for my height. A few days ago the palm of my left hand began to hurt on and off in a spasm sort of way. The soreness is located primarily in the fleshy area around the thumb. I do not have any pain in any of my fingers and am able to flex my wrist without difficulty. I have never had a hand injury and I do not take any medications except calcium pills on a regular basis. What can I do to relieve the pain? What is causing the discomfort?

Answer:

Please note that NetWellness does not provide diagnosis or second opinion.

Two possibilities that cause pain at the fleshy area of the thumb (thenar eminence) are an inflammation of the flexor tendon to the thumb (flexor tenosynovitis) or a compression of the median nerve at the level of the pronator teres muscle in the forearm. A flexor tenosynovitis of thumb tendons may manifest as pain, a nodule at the base of the thumb along the palmar surface, or locking of the thumb after flexing it. Treatments options include splinting, non-steroidal antiinflammatory drugs (NSAID's), local steroid injections, or tendon release surgeries. A Pronator Teres Syndrome typically occurs when the pronator teres muscle enlarges from overuse, typically in athletes such as cyclists. The enlarged muscle compresses the median nerve and causes local pain at the forearm and/or pain in the palm, particularly the thenar eminence. Rest, NSAID's, behavioral modification, and local steroid injections are possible treatment options.

A well-taken history and physical exam are important in diagnosing these conditions or other potential causes of your symptoms.

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Response by:

Raymond  Hong, MD, MBA, FACR Raymond Hong, MD, MBA, FACR
Formerly, Assistant Professor of Medicine
School of Medicine
Case Western Reserve University