Table of ContentsView AllTable of ContentsCausesHow CommonOther CausesTophiDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Causes
How Common
Other Causes
Tophi
Diagnosis
Treatment
Goutis a type ofinflammatory arthritisthat develops when the body has high uric acid levels, known ashyperuricemia. Gout often affects the big toe but can also affect other joints, including the thumb. If you have burning pain in a thumb joint, you could be experiencing agout attack, also called a flare or flare-up.
Gout in the thumb is rare, but it can affect the carpometacarpal (CMC) joint of the thumb or the metacarpophalangeal (MCP).The CMC joint connects the thumb to the wrist and plays a role in the normal functioning of the thumb. The MCP joint is the large joint within the hand, where the thumb joint meets the hand bones. It connects to the CMC joint.
A gout attack in the thumb can be extremely painful because of how often you use your thumbs, from turning doorknobs to writing to grasping a cup. The pain results from activeinflammation, which causes swelling, tenderness, redness, and warmth in the affected thumb.
This article covers the causes of gout in the thumb, its prevalence, and other causes of thumb pain, treatment, and more.
eyepark / Getty Images
What Causes Gout in the Thumb?
Hyperuricemia causes gout. Typically, the kidneys flush out uric acid through the urine, but sometimes, there is just too much for the kidneys to filter. Excess uric acid builds up in the bloodstream. Some uric acid can move from the bloodstream into the joints and form crystals.
When this happens, your immune system will see theurate crystalsas foreign invaders and activate an inflammatory response. Symptoms of an inflammatory response in an affected joing include:
Certain factors increase gout risk.
Genes and Family History
Your risk for gout is higher if the condition runs in your family. The heritability for hyperuricemia (meaning the chance of having a condition due to genetic variants) falls between 45% and 73%.Your risk for gout is higher if you have a first-degree relative (a parent or sibling) with the condition.
Medications
Certain medicines, such asdiuretics(water pills),beta-blockers(used to treat high blood pressure), cyclosporine (an immunosuppressant), and aspirin, can increase your risk for high uric acid levels and gout.
Underlying Health Conditions
Some health conditions, includinghigh blood pressure (hypertension),kidney diseases, anddiabetes, can increase uric acid levels in the bloodstream and lead to gout.People with kidney disease are especially at risk because the kidneys play a crucial role in ridding the body of uric acid, and impaired kidney function can lead to higher uric acid levels.
Hand Injuries
If you get frequent gout attacks, you should avoid injuries to your fingers or thumb. A thumb injury could cause uric acid buildup in the thumb joints.Finger injuries might also lead to a gout flare-up in an affected finger.
Diet
A diet high in purines can result in high uric acid levels.Purines are common compounds in red meat, organ meat, and seafood. They can also be found in alcohol, especially beer, and sugary drinks, including soft drinks.
Studies also suggest being overweight increases the risk of gout, and losing weight can lower your risk.Weight loss can also lessen overall stress on your weight-bearing joints.
Foods to Eat and Avoid With Gout
Age and Sex
People assigned male at birth have a higher risk for gout—mainly because people assigned female usually have lower uric acid levels.However, after menopause, uric acid levels tend to increase and affect everyone similarly.
People assigned male at birth will develop gout earlier (before age 50), while those assigned female at birth tend to develop gout after menopause.
How Common Is Gout in the Thumb?
A 2019 study inArthritis & Rheumatologyfound that nearly 10 million Americans have gout.While gout can affect any joint, the thumb is an unusual place for urate crystals to develop.
The big toe is the most common joint for a gout flare.Other common areas are the knee, elbow,wrist, andfinger joints.
Is Your Thumb Pain Due to Gout or Something Else?
Gout attacks can cause excruciating pain, which makes them hard to miss. However, gout is not the only condition or type of arthritis that affects the thumb. These other conditions are more likely to cause thumb pain.
Rheumatoid Arthritis
Rheumatoid arthritis(RA) is anautoimmune diseasein which the immune system malfunctions and attacks healthy tissues, mainly thesynovial linings of joints. RA frequently affects the joints of the hands, including the fingers and thumbs.
Like gout, thumb RA causes inflammation of the CMC and MCP joints, leading to severe pain and swelling. These symptoms might make it harder to carry out daily tasks, especially those involving grasping and gripping objects, such as writing, holding a glass or mug, or using kitchen tools.
Gout vs. Rheumatoid Arthritis: What Are the Differences?
Psoriatic Arthritis
Like RA,psoriatic arthritis(PsA) is an autoimmune arthritis. Many people with PsA also havepsoriasis, anautoimmune skin disease.
When PsA affects the hands, inflammation can cause swelling and stiffness in the hand and finger joints.People with PsA will have inflammation at the thumb’sinterphalangeal (IP) joint, which is the first joint, near the tip of the thumb and right below the fingernail.
Psoriatic Arthritis vs. Gout: What Are the Differences?
Pseudogout
Pseudogoutis an inflammatory arthritis that forms when calcium pyrophosphate crystals deposit in the joints and soft tissues.It can cause similar symptoms to gout and frequently affects the wrists and hands.
Pseudogout vs. Gout: What’s the Difference?
Injury or Infection
A swollen thumb can result from abacterial nail infectionor an injury.A thumbnail infection can cause pain, redness, and swelling. Any injury to the thumb’s bones and ligaments can lead to pain and swelling of the thumb joints.
Osteoarthritis
The most common type of arthritis of the thumb isosteoarthritis(OA).OA can cause damage to the thumb joints due to natural wear and tear over time.
OA causescartilageto wear away, which eventually causes bone-on-bone pain (bones rubbing against each other) and joint damage. Cartilage is the material that acts as a cushion and allows bones to glide gently against each other.
Combination of Conditions
Gout and other conditions that cause joint pain, specifically thumb pain, can coexist. For example, one 2019 study found up to 6% of people with RA also had gout.Gout can also coexist with PsAand osteoarthritis.RA, PsA, and OA are all conditions that might increase your risk for gout.
A Telltale Sign of Gout in the Thumb: Tophi
Tophiare a symptom of gout.They are large, hardened masses of uric acid crystals within and around the joints. These masses can cause pain, joint deformity, and limited range of motion.
Tophi can affect any joint, including in the fingers and thumbs. It is a sign of advanced or chronic gout.
When tophi affect the small joints of the thumbs and fingers, physical changes and limited movement will occur.Joint damage or infection can also occur.
How Long Does Gout Last?
How Providers Diagnose Gout in the Thumb
A gout attack of the thumb or other joint area can last up to 10 days.However, if you seek treatment, your recovery time could be shorter. If you think you might have gout, see a healthcare provider.
A healthcare provider will typically examine your thumb for lumps that might indicate tophi. You will be asked about your symptoms, when they started, and whether this is your first gout flare-up.
The healthcare provider will also want to know about any underlying conditions, medications you are taking, and any family history of gout or other arthritic conditions.
If your healthcare provider suspects gout or is unsure of the cause of symptoms, they will request additional tests, including:
Treatment for Gout in the Thumb
Treatment for an acute (short-term) gout flare of the thumb typically involves medications to reduce inflammation and manage pain.
Treatment options for an acute flare include:
If you have repeat gout flare-ups, your healthcare provider may prescribe additional treatments to prevent gout from becoming chronic and leading to tophi.
Such medications include:
Surgery is recommended in cases where there is thumb damage, nerve compression, or tophi infection.Fortunately, surgery is rarely needed to treat gout-affected joints.
How Gout Is Treated
Lifestyle and Self-Care
Some lifestyle modifications and self-care measures can help you to manage gout symptoms and prevent flares.
People with gout should avoid foods and beverages high in purines. Such foods and beverages include:
In addition to watching what you eat, you shouldstay hydrated, which can reduce uric acid levels and recovery time.
Applying ice packs and cold compresses to the affected thumb can help manage pain and swelling. You can apply ice for up to 20 minutes several times a day.
Last, avoid using the affected thumb during the gout flare. Ask your healthcare provider if a splint or brace might help to manage your thumb gout symptoms.
How to Prevent Gout
Summary
Gout is a type of arthritis that develops when uric acid crystals are deposited in a joint. Risk factors for gout include family history, older age, being assigned male at birth, certain medical conditions and medications, and a diet high in purines.
A thumb injury could lead to a build-up of uric acid crystals in one of your thumbs, and if the levels of uric acid are not managed, you could experience a gout flare-up in the thumb.
Contact your healthcare provider if you develop a sudden and severe swelling and pain in your thumb. This is especially important if you have already been diagnosed with gout or are at high risk for the condition.
Treatment can help reduce symptoms and prevent future attacks, chronic gout, and tophi. Surgery is rarely needed to treat gout in the thumb, but it may be needed if joint damage related to tophi occurs.
20 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Ian Jason M, Muramatsu K, Tani Y, Kobayashi M.Atypical erosive tophaceous gout with severe osteolysis around multiple joints of the digits: A case report.J. Orthop. Res. 2022;1(4):100101. doi:10.1016/j.jorep.2022.100101Dalbeth N, Stamp LK, Merriman TR.The genetics of gout: towards personalised medicine?BMC Med. 2017;15(1):108. doi:10.1186/s12916-017-0878-5Helget LN, Mikuls TR.Environmental triggers of hyperuricemia and gout.Rheum Dis Clin North Am. 2022;48(4):891-906. doi:10.1016/j.rdc.2022.06.009MacFarlane LA, Kim SC.Gout: a review of non-modifiable and modifiable risk factors.Rheum Dis Clin North Am. 2014;40(4):581-604. doi:10.1016/j.rdc.2014.07.002Ou SH, Chou CL, Lin CW, et al.Association between gout and injury risk: a national retrospective cohort study.Int J Environ Res Public Health. 2020;17(10):3679. doi:10.3390/ijerph17103679Zhang Y, Chen S, Yuan M, Xu Y, Xu H.Gout and diet: a comprehensive review of mechanisms and management.Nutrients. 2022;14(17):3525. doi:10.3390/nu14173525Chen-Xu M, Yokose C, Rai SK, Pillinger MH, Choi HK.Contemporary prevalence of gout and hyperuricemia in the United States and decadal trends: the National Health and Nutrition Examination Survey, 2007-2016.Arthritis Rheumatol. 2019;71(6):991-999. doi:10.1002/art.40807American Academy of Orthopaedic Surgeons.Gout.Boeckstyns, M.E.H. (2016).The rheumatoid thumb. In: Chung, K. (eds) Clinical Management of the Rheumatoid Hand, Wrist, and Elbow. Springer, Cham. doi:10.1007/978-3-319-26660-2_21Mathew AJ, Ganapati A, Panwar J, Koshy V, Desai A, Danda D.Magnetic resonance imaging evidence of inflammation at interphalangeal joint of thumb - a distinct entity in psoriatic arthritis.Int J Rheum Dis. 2021;24(12):1467-1472. doi:10.1111/1756-185X.14156American Society for Surgery of the Hand.Pseudogout.Nemour KidsHealth.Paronychia.Hospital for Special Surgery.Basal joint arthritis: osteoarthritis of the thumb.Chiou A, England BR, Sayles H, et al.Coexistent hyperuricemia and gout in rheumatoid arthritis: Associations withcomorbidities, disease activity, and mortality.Arthritis Care Res (Hoboken). 2020;72(7):950-958. doi:10.1002/acr.23926Felten R, Duret PM, Gottenberg JE, Spielmann L, Messer L.At the crossroads of gout and psoriatic arthritis: “psout.”Clin Rheumatol. 2020;39(5):1405-1413. doi:10.1007/s10067-020-04981-0Chen D, Xu H, Sun L, Li Y, Wang T, Li Y.Assessing causality between osteoarthritis with urate levels and gout: a bidirectional Mendelian randomization study.Osteoarthritis Cartilage. 2022;30(4):551-558. doi:10.1016/j.joca.2021.12.001Hospital for Special Surgery.The 4 stages of gout progression (and how to stop gout from getting worse).National Institute of Arthritis and Musculoskeletal and Skin Diseases.Gout: diagnosis, treatment, and steps to take.Dakkak M, Lanney H.Management of gout: update from the American College of Rheumatology.Am Fam Physician. 2021;104(2):209-210.Słowińska I, Słowiński R, Rutkowska-Sak L.Tophi - surgical treatment.Reumatologia. 2016;54(5):267-272. doi:10.5114/reum.2016.63819
20 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Ian Jason M, Muramatsu K, Tani Y, Kobayashi M.Atypical erosive tophaceous gout with severe osteolysis around multiple joints of the digits: A case report.J. Orthop. Res. 2022;1(4):100101. doi:10.1016/j.jorep.2022.100101Dalbeth N, Stamp LK, Merriman TR.The genetics of gout: towards personalised medicine?BMC Med. 2017;15(1):108. doi:10.1186/s12916-017-0878-5Helget LN, Mikuls TR.Environmental triggers of hyperuricemia and gout.Rheum Dis Clin North Am. 2022;48(4):891-906. doi:10.1016/j.rdc.2022.06.009MacFarlane LA, Kim SC.Gout: a review of non-modifiable and modifiable risk factors.Rheum Dis Clin North Am. 2014;40(4):581-604. doi:10.1016/j.rdc.2014.07.002Ou SH, Chou CL, Lin CW, et al.Association between gout and injury risk: a national retrospective cohort study.Int J Environ Res Public Health. 2020;17(10):3679. doi:10.3390/ijerph17103679Zhang Y, Chen S, Yuan M, Xu Y, Xu H.Gout and diet: a comprehensive review of mechanisms and management.Nutrients. 2022;14(17):3525. doi:10.3390/nu14173525Chen-Xu M, Yokose C, Rai SK, Pillinger MH, Choi HK.Contemporary prevalence of gout and hyperuricemia in the United States and decadal trends: the National Health and Nutrition Examination Survey, 2007-2016.Arthritis Rheumatol. 2019;71(6):991-999. doi:10.1002/art.40807American Academy of Orthopaedic Surgeons.Gout.Boeckstyns, M.E.H. (2016).The rheumatoid thumb. In: Chung, K. (eds) Clinical Management of the Rheumatoid Hand, Wrist, and Elbow. Springer, Cham. doi:10.1007/978-3-319-26660-2_21Mathew AJ, Ganapati A, Panwar J, Koshy V, Desai A, Danda D.Magnetic resonance imaging evidence of inflammation at interphalangeal joint of thumb - a distinct entity in psoriatic arthritis.Int J Rheum Dis. 2021;24(12):1467-1472. doi:10.1111/1756-185X.14156American Society for Surgery of the Hand.Pseudogout.Nemour KidsHealth.Paronychia.Hospital for Special Surgery.Basal joint arthritis: osteoarthritis of the thumb.Chiou A, England BR, Sayles H, et al.Coexistent hyperuricemia and gout in rheumatoid arthritis: Associations withcomorbidities, disease activity, and mortality.Arthritis Care Res (Hoboken). 2020;72(7):950-958. doi:10.1002/acr.23926Felten R, Duret PM, Gottenberg JE, Spielmann L, Messer L.At the crossroads of gout and psoriatic arthritis: “psout.”Clin Rheumatol. 2020;39(5):1405-1413. doi:10.1007/s10067-020-04981-0Chen D, Xu H, Sun L, Li Y, Wang T, Li Y.Assessing causality between osteoarthritis with urate levels and gout: a bidirectional Mendelian randomization study.Osteoarthritis Cartilage. 2022;30(4):551-558. doi:10.1016/j.joca.2021.12.001Hospital for Special Surgery.The 4 stages of gout progression (and how to stop gout from getting worse).National Institute of Arthritis and Musculoskeletal and Skin Diseases.Gout: diagnosis, treatment, and steps to take.Dakkak M, Lanney H.Management of gout: update from the American College of Rheumatology.Am Fam Physician. 2021;104(2):209-210.Słowińska I, Słowiński R, Rutkowska-Sak L.Tophi - surgical treatment.Reumatologia. 2016;54(5):267-272. doi:10.5114/reum.2016.63819
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Ian Jason M, Muramatsu K, Tani Y, Kobayashi M.Atypical erosive tophaceous gout with severe osteolysis around multiple joints of the digits: A case report.J. Orthop. Res. 2022;1(4):100101. doi:10.1016/j.jorep.2022.100101Dalbeth N, Stamp LK, Merriman TR.The genetics of gout: towards personalised medicine?BMC Med. 2017;15(1):108. doi:10.1186/s12916-017-0878-5Helget LN, Mikuls TR.Environmental triggers of hyperuricemia and gout.Rheum Dis Clin North Am. 2022;48(4):891-906. doi:10.1016/j.rdc.2022.06.009MacFarlane LA, Kim SC.Gout: a review of non-modifiable and modifiable risk factors.Rheum Dis Clin North Am. 2014;40(4):581-604. doi:10.1016/j.rdc.2014.07.002Ou SH, Chou CL, Lin CW, et al.Association between gout and injury risk: a national retrospective cohort study.Int J Environ Res Public Health. 2020;17(10):3679. doi:10.3390/ijerph17103679Zhang Y, Chen S, Yuan M, Xu Y, Xu H.Gout and diet: a comprehensive review of mechanisms and management.Nutrients. 2022;14(17):3525. doi:10.3390/nu14173525Chen-Xu M, Yokose C, Rai SK, Pillinger MH, Choi HK.Contemporary prevalence of gout and hyperuricemia in the United States and decadal trends: the National Health and Nutrition Examination Survey, 2007-2016.Arthritis Rheumatol. 2019;71(6):991-999. doi:10.1002/art.40807American Academy of Orthopaedic Surgeons.Gout.Boeckstyns, M.E.H. (2016).The rheumatoid thumb. In: Chung, K. (eds) Clinical Management of the Rheumatoid Hand, Wrist, and Elbow. Springer, Cham. doi:10.1007/978-3-319-26660-2_21Mathew AJ, Ganapati A, Panwar J, Koshy V, Desai A, Danda D.Magnetic resonance imaging evidence of inflammation at interphalangeal joint of thumb - a distinct entity in psoriatic arthritis.Int J Rheum Dis. 2021;24(12):1467-1472. doi:10.1111/1756-185X.14156American Society for Surgery of the Hand.Pseudogout.Nemour KidsHealth.Paronychia.Hospital for Special Surgery.Basal joint arthritis: osteoarthritis of the thumb.Chiou A, England BR, Sayles H, et al.Coexistent hyperuricemia and gout in rheumatoid arthritis: Associations withcomorbidities, disease activity, and mortality.Arthritis Care Res (Hoboken). 2020;72(7):950-958. doi:10.1002/acr.23926Felten R, Duret PM, Gottenberg JE, Spielmann L, Messer L.At the crossroads of gout and psoriatic arthritis: “psout.”Clin Rheumatol. 2020;39(5):1405-1413. doi:10.1007/s10067-020-04981-0Chen D, Xu H, Sun L, Li Y, Wang T, Li Y.Assessing causality between osteoarthritis with urate levels and gout: a bidirectional Mendelian randomization study.Osteoarthritis Cartilage. 2022;30(4):551-558. doi:10.1016/j.joca.2021.12.001Hospital for Special Surgery.The 4 stages of gout progression (and how to stop gout from getting worse).National Institute of Arthritis and Musculoskeletal and Skin Diseases.Gout: diagnosis, treatment, and steps to take.Dakkak M, Lanney H.Management of gout: update from the American College of Rheumatology.Am Fam Physician. 2021;104(2):209-210.Słowińska I, Słowiński R, Rutkowska-Sak L.Tophi - surgical treatment.Reumatologia. 2016;54(5):267-272. doi:10.5114/reum.2016.63819
Ian Jason M, Muramatsu K, Tani Y, Kobayashi M.Atypical erosive tophaceous gout with severe osteolysis around multiple joints of the digits: A case report.J. Orthop. Res. 2022;1(4):100101. doi:10.1016/j.jorep.2022.100101
Dalbeth N, Stamp LK, Merriman TR.The genetics of gout: towards personalised medicine?BMC Med. 2017;15(1):108. doi:10.1186/s12916-017-0878-5
Helget LN, Mikuls TR.Environmental triggers of hyperuricemia and gout.Rheum Dis Clin North Am. 2022;48(4):891-906. doi:10.1016/j.rdc.2022.06.009
MacFarlane LA, Kim SC.Gout: a review of non-modifiable and modifiable risk factors.Rheum Dis Clin North Am. 2014;40(4):581-604. doi:10.1016/j.rdc.2014.07.002
Ou SH, Chou CL, Lin CW, et al.Association between gout and injury risk: a national retrospective cohort study.Int J Environ Res Public Health. 2020;17(10):3679. doi:10.3390/ijerph17103679
Zhang Y, Chen S, Yuan M, Xu Y, Xu H.Gout and diet: a comprehensive review of mechanisms and management.Nutrients. 2022;14(17):3525. doi:10.3390/nu14173525
Chen-Xu M, Yokose C, Rai SK, Pillinger MH, Choi HK.Contemporary prevalence of gout and hyperuricemia in the United States and decadal trends: the National Health and Nutrition Examination Survey, 2007-2016.Arthritis Rheumatol. 2019;71(6):991-999. doi:10.1002/art.40807
American Academy of Orthopaedic Surgeons.Gout.
Boeckstyns, M.E.H. (2016).The rheumatoid thumb. In: Chung, K. (eds) Clinical Management of the Rheumatoid Hand, Wrist, and Elbow. Springer, Cham. doi:10.1007/978-3-319-26660-2_21
Mathew AJ, Ganapati A, Panwar J, Koshy V, Desai A, Danda D.Magnetic resonance imaging evidence of inflammation at interphalangeal joint of thumb - a distinct entity in psoriatic arthritis.Int J Rheum Dis. 2021;24(12):1467-1472. doi:10.1111/1756-185X.14156
American Society for Surgery of the Hand.Pseudogout.
Nemour KidsHealth.Paronychia.
Hospital for Special Surgery.Basal joint arthritis: osteoarthritis of the thumb.
Chiou A, England BR, Sayles H, et al.Coexistent hyperuricemia and gout in rheumatoid arthritis: Associations withcomorbidities, disease activity, and mortality.Arthritis Care Res (Hoboken). 2020;72(7):950-958. doi:10.1002/acr.23926
Felten R, Duret PM, Gottenberg JE, Spielmann L, Messer L.At the crossroads of gout and psoriatic arthritis: “psout.”Clin Rheumatol. 2020;39(5):1405-1413. doi:10.1007/s10067-020-04981-0
Chen D, Xu H, Sun L, Li Y, Wang T, Li Y.Assessing causality between osteoarthritis with urate levels and gout: a bidirectional Mendelian randomization study.Osteoarthritis Cartilage. 2022;30(4):551-558. doi:10.1016/j.joca.2021.12.001
Hospital for Special Surgery.The 4 stages of gout progression (and how to stop gout from getting worse).
National Institute of Arthritis and Musculoskeletal and Skin Diseases.Gout: diagnosis, treatment, and steps to take.
Dakkak M, Lanney H.Management of gout: update from the American College of Rheumatology.Am Fam Physician. 2021;104(2):209-210.
Słowińska I, Słowiński R, Rutkowska-Sak L.Tophi - surgical treatment.Reumatologia. 2016;54(5):267-272. doi:10.5114/reum.2016.63819
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