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Thumb Pain Near the Fingernail: Symptom & Causes

An illustration of a side angle of a right hand facing down and fingers pointing left. Red concentric circles show pain near the base of the fingernail. The skin is medium-dark peach toned, and the fingernail is a lighter pink. The rest of the fingers are relaxed naturally.
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Written by Andrew Le, MD.
Medically reviewed by
Last updated April 2, 2024

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Understand your thumb pain near the fingernail symptoms, including 2 causes & common questions.

2 causes of thumb pain near the fingernail

This list does not constitute medical advice and may not accurately represent what you have.

Nail infection (paronychia)

Paronychia is an infection of the skin of the fingers or toes, at the place where the skin folds down to meet the nail.

Acute, or sudden onset, paronychia is caused by the staphylococcus bacteria. The organism can gain entry if the nail is cracked, broken, bitten, or trimmed too closely.

Chronic, or ongoing, paronychia is caused by a fungus. Anyone whose work requires their hands to be wet much of the time is susceptible.

People with diabetes or a weakened immune system are more susceptible to nail infections.

Symptoms include sore, reddened, swollen skin around the nail, sometimes with pus collecting under the skin.

Diagnosis is made through physical examination and sometimes skin culture to identify the organism involved.

Treatment for acute paronychia involves having a medical provider clean the wounded nail and drain any infection, and sometimes provide a course of antibiotics.

Treatment for the chronic form involves keeping the skin dry and using an antifungal medication on the affected nail.

Rarity: Rare

Top Symptoms: spontaneous finger pain, fingernail pain, fingernail swelling

Urgency: Phone call or in-person visit

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Psoriatic arthritis

Psoriatic arthritis is a complication of psoriasis, which causes the skin to become thickened, red, and scaly. Arthritis may appear before or after the psoriasis appears.

Both conditions are autoimmune diseases, where the body attacks itself, and are thought to be caused by genetic and environmental factors.

Most susceptible are people from 30 to 50 years of age with a family history of the disease and who already have psoriasis.

Symptoms include the joints on one or both sides of the body becoming painful, swollen, and hot; swelling and deformity of the fingers and toes; pitted, flaking fingernails; foot pain in the heels and soles; and joint pain in the low back pain.

It is important to seek treatment, as psoriatic arthritis can permanently damage the joints, eyes, and heart.

Diagnosis is made through physical examination, x-rays, and MRI. Blood tests and joint fluid tests can confirm psoriatic arthritis.

Treatment includes over-the-counter, nonsteroidal anti-inflammatory drugs; anti-rheumatic medication; immunosuppressants; and steroid injections for the joints. Surgery to replace damaged joints may also be tried.

Chronic nail infection (paronychia)

Chronic fingernail infection (Paronychia) is caused by repeated damage to the cuticle (the thin layer of skin that covers the base of the nail). The cuticle protects the nail from infection, and when it's damaged again-and-again, it can predispose someone to infections of the nail (paronychia).

You can treat this at home with a number of changes - 1) moisturizing with lotion, 2) protecting your hands from water by using light cotton gloves under heavier-duty vinyl gloves, 3) avoiding any nail polish/remover/hardener/conditioner, 4) using mild soaps to wash your hands and drying them completely and carefully, 5) using a topical steroid to promote healing

Rarity: Rare

Top Symptoms: spontaneous finger pain, fingernail pain, cuticle loss, fingernail swelling

Urgency: Phone call or in-person visit

Cellulitis

Cellulitis is a bacterial infection of the deep layers of the skin. It can appear anywhere on the body but is most common on the feet, lower legs, and face.

The condition can develop if Staphylococcus bacteria enter broken skin through a cut, scrape, or existing skin infection such as impetigo or eczema.

Most susceptible are those with a weakened immune system, as from corticosteroids or chemotherapy, or with impaired circulation from diabetes or any vascular disease.

Symptoms arise somewhat gradually and include sore, reddened skin.

If not treated, the infection can become severe, form pus, and destroy the tissue around it. In rare cases, the infection can cause blood poisoning or meningitis.

Symptom of severe pain, fever, cold sweats, and fast heartbeat should be seen immediately by a medical provider.

Diagnosis is made through physical examination.

Treatment consists of antibiotics, keeping the wound clean, and sometimes surgery to remove any dead tissue. Cellulitis often recurs, so it is important to treat any underlying conditions and improve the immune system with rest and good nutrition.

Questions your doctor may ask about thumb pain near the fingernail

  • Let's examine your thumb a bit. What makes your thumb hurt worse?
  • Do you repetitively use your thumb and wrist?
  • Press on the thumb along the hand. Does this hurt?
  • Does this hand movement cause you pain? (This is known as Finkelstein test.)

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

Thumb pain near the fingernail symptom checker statistics

People who have experienced thumb pain near the fingernail have also experienced:

  • 22% Thumb Pain
  • 9% Fingernail Changes
  • 4% Skin-Colored Hand Bump

People who have experienced thumb pain near the fingernail were most often matched with:

  • 50% Nail Infection (Paronychia)
  • 50% Chronic Nail Infection (Paronychia)

People who have experienced thumb pain near the fingernail had symptoms persist for:

  • 32% Less than a week
  • 24% Over a month
  • 22% Less than a day

Source: Aggregated and anonymized results from Buoy Assistant.

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The stories shared below are not written by Buoy employees. Buoy does not endorse any of the information in these stories. Whenever you have questions or concerns about a medical condition, you should always contact your doctor or a healthcare provider.
Jeff brings to Buoy over 20 years of clinical experience as a physician assistant in urgent care and internal medicine. He also has extensive experience in healthcare administration, most recently as developer and director of an urgent care center. While completing his doctorate in Health Sciences at A.T. Still University, Jeff studied population health, healthcare systems, and evidence-based medi...
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