About two months ago I woke up and my thumb was really sore. This in and of itself is not terribly unusual since I work out a lot and I have the occasional ache: no pain, no gain. Also, at my age (63), it can be expected that I wake up some days with something not working the way it used to. I figured that it would get better in a few days, but when it didn’t, I contacted my primary care physician who recommended a brace for my thumb. With no improvement–in fact, the pain was beginning to radiate up my arm–I was referred to an orthopaedist who diagnosed me with Trigger Thumb. He gave me another brace which made a big difference and put me on a series of anti-inflammatory steroids. The pain dissapated but the limited range of motion of my thumb continued to get worse. We tried a second round of the steroids, but unfortunately, I could no longer bend my thumb. After consulting with the orthopaedist, we decided on surgery.
What is Trigger Finger (not to be confused with trigger happy)? It is a condition where the finger may have difficulty bending or straightening out; there may also be a popping or snapping in one of the joints. This is often accompanied by pain and/or swelling. In my case, the thumb simply would not bend; the few times were it did (like while I was gardening), the discomfort was immense.
It is caused when the tendon sheath in the palm becomes inflamed, making it difficult for the tendon to glide smoothly. There is a system of pulleys that make the fingers move, but the inflammation stops the tendon just like a not in a rope would prevent it from going through a pulley. We do not know exactly why Trigger Finger occurs, but risk factors include repetitive hand use that requires gripping and certain medical conditions associated with the joints; men between the ages of 40-60 are at the greatest risk.
There are a number of ways to treat Trigger Finger. First, as my doctor recommended, a splint or a brace can help to immobilize the joint and allow the inflammation to go down, thus restoring movement. NSAIDs (non-steroidal anti-inflammatory drugs) like Ibuprofen can make a difference too, but not everyone (including me) can take them. Sometimes an injection of steroids into the affected area can be a solution, but if you choose this route and it fails, surgery will not be an option for at least a few months; my doctor and I chose not to do this because the oral steroids did not seem to solve the issue. Finally, there is a simple outpatient surgery that can be done under local or general anesthesia; I have a strong vasovagal response so we opted for the general. Full recovery from surgery takes about two weeks, and in my case involved very little discomfort.
Why is all of this important? I have blogged before about how we need not accept that certain conditions that develop as we age will be permanent. Sometimes, we seem to say, “oh well, I am getting older, and I guess this thing just doesn’t work anymore.” There are often easy and painless solutions that will allow us to keep active and independent. In my case, I am right-handed and that is where the issue was. Not writing, using a keyboard, or being able to cook, clean, etc., simply was not an option. When something new pops up, it is okay to wait a few days to see if it resolves (a lot of times it does), but if you cannot live with a certain limitation, contact your doctor.
In the final analysis, how would I rate the experience of treating my Trigger Finger? I would definitely give it a “thumbs up!”
Kosher Fitness 