I had an itchy trigger finger ... so he shot me

[hrj]

For about the last month I've had this annoying pain in my left thumb -- the bottom joint. At particular angles and pressures, it almost felt like the joint was dislocated or the bone was broken ... except clearly it wasn't. Sometimes it would do this odd little "clicking" thing when I moved it. Then it sort of settled down into behaving as if the flexor tendon was too short. Oh, and things that required my thumb to press hard in a flexed direction hurt like a sonuvabitch. (Things like ... oh ... shifting the left gear shift on my bike, or fastening my bra behind my back.) I tried about a week each of putting a brace on at night and trying to avoid using it during the day, of taking regular aspirin, and of doing regular manipulation and forced flexing. No change for any of them. I did some deep soul searching into any activity that might be causing repetitive stress or motion in that particular joint. Nothing. (Now if it had been my right hand, I'd have all sorts of possible causes.)

So finally yesterday I called up Kaiser and asked the advice nurse what her advice was. She set me up with an appointment with my primary this morning, who poked and prodded then got on the computer and set me up a consultation in orthopedics ... immediately. (This isn't "immediately as in an emergency" but "immediately as in they have a very well oiled machine".) X-rays and more poking and prodding and it turns out I have an inflamed tendon of the type nicknamed "trigger finger" (from that "clicking" thing). The orthopedist discussed several levels of potential treatment and we decided that since I'd already tried the aspirin-and-taking-it-easy regimen, we'd go straight to the cortisone shot. Did it right then and there. I tell you, every time I go to Kaiser for something they've gotten smoother and more efficient. So I'm supposed to do an ibuprofin regimen and see what happens. I still wish there were some clear cause I could identify. I honestly don't do that much with my left thumb.

Comments

[klwilliams.livejournal.com]

When I go to the chiropractor she often adjusts my thumbs and elbows. You might just have knocked it out of whack at one point and it just needs to be eased back into place.

[isoltelequite.livejournal.com]

For that trigger thumb, it's all about gliding a tendon which is a bit inflamed through a pulley which may be constricting it. And literally, the tendon can have an hourglass shape or an area where it is larger in girth than other areas of the tendon. As it is pulled through the A1 pulley specifically, it is too large for the tight hole and it catches and snaps when it releases through it. So cutting the inflammation is key, hence the cortisone shot, the nonsteroidal anti-inflammatories (aspirin or ibuprofen, etc class), elevation (to use gravity to help keep hydrostatic fluid pressure out of the equation as much as possible), and rest (QUIT OVERUSING THE THING!!!!) are the answers. The more drastic solution is to surgically release that A1 pulley. Straightforward enough for a hand surgeon to do, but *does* run the risk of possible neurovascular injuries. That's my quick take on the subject, so you appreciate the scientific scope of the matter.

And I've had trigger thumbs since grade school. It never got me out of violin lessons, but it also never kept me from completing my residencies and fellowships in any way. Still never had anything done about them either. Clicking away...

[hrj.livejournal.com]

The thing about "quit overusing it" is that I can't for the life of me figure out what I might be doing to "overuse" it. I'm doing nothing unusual or stressful involving my left thumb.