Trigger Finger - Anyone been treated for it?

[hiram.k.hackenbacker]

I haven't sought a medical opinion yet, but I'm fairly sure that when I do the prognosis will be Trigger Finger to the ring finger on my left hand. I would think the cause of this is undoubtedly a few decades of playing bass. From what I've read, it's probably not going to get better on its own and will most likely deteriorate. In fact it has worsened dramatically since the beginning of the year. I've already had to stop wearing my wedding ring as it is too painful and clenching and opening my fist in the morning is a surreal experience as my ring finger just stays glued to my palm. There appears to me a few options regarding treatment, obviously the one I don't want to take is surgery as that will put me out of action for a while.

So, has anyone been treated for it and if so, how did it go?

[Chiliwailer]

Really sorry to hear about your situation mate.

I can't help, but as I've had great results with acupuncture I looked at this

http://www.acupuncture.org.uk/public-content/public-ask-an-expert/ask-an-expert-muscles-and-bones/ask-an-expert-muscles-and-bones-hands-and-fingers/3707-would-acupuncturist-help-for-trigger-thumb.html

it's not exactly helpful, but another iron for the fire perhaps.

Best of luck with the issue pal

[hiram.k.hackenbacker]

[quote name='Chiliwailer' timestamp='1461174674' post='3032208']
Really sorry to hear about your situation mate.

I can't help, but as I've had great results with acupuncture I looked at this

http://www.acupuncture.org.uk/public-content/public-ask-an-expert/ask-an-expert-muscles-and-bones/ask-an-expert-muscles-and-bones-hands-and-fingers/3707-would-acupuncturist-help-for-trigger-thumb.html

it's not exactly helpful, but another iron for the fire perhaps.

Best of luck with the issue pal
[/quote]
Thanks Daniel. I would definitely be open to acupuncture again if it was recommended as I had it some years ago when I damaged my radial nerve. That and some fairly rigorous physio made it bearable at least.

[Chiliwailer]

[quote name='hiram.k.hackenbacker' timestamp='1461175253' post='3032216']

Thanks Daniel. I would definitely be open to acupuncture again if it was recommended as I had it some years ago when I damaged my radial nerve. That and some fairly rigorous physio made it bearable at least.
[/quote]

That's good to hear, it's only as good as the practitioner so hope you find a good one if you end going for it.

[ivansc]

I had trigger finger.
Right hand & it got so bad my first and second fingers would lock up whilst I was playing and I would have to stop and straighten the fingers out with my other hand before I could continue.
Was told by the doc that it was the equivalent of carpal tunnel syndrome but in the metacarpals.
Said I should stop playing bass to give the joints a rest.
A friend had surgery which made his problems ten times worse, as did the Chairman of our Parish Council ( a non-bass or guitar player) and HIS post-op symptoms were so bad he wound up with kidney failure due to OD-ing on pain killers after the op.
In both these cases, the affected fingers ended up permanently bent double against the palm.
I cancelled my appointment with the surgeon and played guitar instead for FOUR years before I risked having another go on bass.
Fortunately the reduced stress from guitar instead of bass was enough to allow it to heal.
I now warm up properly before I play & have had no recurrence.

But now of course I have issues with arthritis in my thumb and finger joints, among other places...
Cant win. But then I am 72 in June....

[NancyJohnson]

I've had four operations on different fingers (so far). Left thumb, left middle, right ring, right middle. Just for the record two were done privately, two on the NHS, all by the same consultant (Charles Pailthorpe [url="http://www.circlehealth.co.uk/consultants/charles-pailthorpe"]http://www.circlehealth.co.uk/consultants/charles-pailthorpe[/url]), all were done professionally and without issue.

The procedure is a quick and it's a fairly simple surgery (just look up A1 pulley release on the tube of you); under ten minutes and the fix is [u]instant[/u] and permanent. The first evening after the operation has always been uncomfortable but thereafter recovery time is [b]very [/b]quick. The only reason I didn't play bass for a few days was just as a precaution to pulling open the lesion.

If I can give you one or two bits of advice, it would be to always insist on the surgical procedure. Cortizone injections, acupuncture, snake oil and any other miracle cures will categorically not resolve the issue and it will certainly not 'get better' on its own; the very nature of the condition is growth of the gristley pulley restricting tendon movement...it will not ungrow any more than your fingernails will recede back into their nailbeds. Resting the joint will not make the pulley shrink.

In closing, I'd say get it sorted sooner rather than later. Much as I love the NHS, their slacking and sidestepping on one finger caused the condition to worsen, resulting in damage both to the tendon and the sleeve surrounding it (the evening of that op was [i]very [/i]bad; worse pain I've experienced and it wasn't restricted to the hand). My consultant remarked I would likely experience issues with the finger in later life, but as of yet, it's been fine.

Get it sorted.

Edited April 22, 2016 by NancyJohnson

[NancyJohnson]

*Oh, and it's nothing to do with playing guitar either. It's in your genes and is passed down through the male side of the family. Nordic/Viking bloodline, apparently (yes, I'm being serious!).

[hiram.k.hackenbacker]

Wow, two of ends of the spectrum there then. Everything I've read about it, if indeed that is what I have, is that anything other than surgery is just alleviating the symptoms rather than dealing with the cause. I didn't realise that if I do have surgery that I would be able to play so soon afterwards if all went well. I've already picked a window of Jan 2017 which is when I'm least busy gig wise, so if I can get referred now, I might be able to achieve that. If all else fails I'm prepared to go private.

Thanks for taking the time to tell your stories.

I woke up this morning and it had completely locked. I couldn't extend the finger on its own. The writing is on the wall as they say.

[FlatEric]

Another side to the story. . .

I had it in my LH little finger.

I put up with it for ages and then went to the doc.

He explained what it was and what could be done and said that in some cases, it does go away.

Most people I spoke to said no way it would but about 3 months later, it started to ease off and
has now gone.

I did have an operation on my hand (not related) around a year later and did wonder if it may
come back.
Five ish years later, it's still fine.

Not sure if that has helped - you, in your case, may need surgery,

Good luck.

[NancyJohnson]

The image below is pretty succinct to those in the know. The pulley is effectively a bridge of cartlidge-type material (much like the stuff you get on chicken wings), that the tendon moves through to allow your finger to flex back and forth. The A1 is the pulley in the palm of your hand, the A2 is between the lower two knuckles on finger (and so on).

In a case of trigger-finger/thumb, the pulley grows both inwards (squeezing and restricting the tendon) and outwards (producing a pronounced bump on the palm), so as I've posted previously, acupuncture/cortizone etc. isn't a cure. The operative procedure simply slices through the pulley, turning it in a bascule (ie Tower Bridge), releasing the tightness and allowing the tendon to move freely.

I've suffered zero ill-effects; I am however experiencing the telltail signs that the little finger on my right hand is going the same way as the four I've had done previously. Ominous occassional triggering, but nothing bad just yet.

Edited April 22, 2016 by NancyJohnson

[ivansc]

Nancy - I wish I had read your post before MY experience with the local hand surgeon.
Really makes me wonder how ham fisted the guy is to have screwed up what superficially LOOKS like a pretty straightforward op.
I watched a YouTube video of the procedure and just don't understand what this clown could have done to mess two (that I know of) people's hands up so badly.
Am also SO glad I decided to try rest and improving my playing habits, which ten years on is still keeping trigger finger at bay.
THANKS for the advice and explanation.
Do't suppose you have any advice on arthritic bone growth in thumb base joints, do you?

*sigh*

[ivansc]

[quote name='NancyJohnson' timestamp='1461303265' post='3033410']
*Oh, and it's nothing to do with playing guitar either. It's in your genes and is passed down through the male side of the family. Nordic/Viking bloodline, apparently (yes, I'm being serious!).
[/quote]

With my last name of Carling & coming from a long line of fair haired blue eyed folks, you could have a point!

[NancyJohnson]

[quote name='ivansc' timestamp='1461330133' post='3033758']
Do't suppose you have any advice on arthritic bone growth in thumb base joints, do you?
[/quote]

My consultant remarked I may need a CMC Anthroplasty at some stage as I have (arthritic) pain and general clickiness deep inside in my right thumb joint. I've been told this has almost definitely been bought on by my playing over the last 30+ years. I wear a Mueller Thumb Stabilizer (Amazon!) when it gets too painful/inflamed and this helps restrict movement.

The operation for that baby looks freaking horrific.

[hiram.k.hackenbacker]

Just rang the Doctor's. There are no appointments for the whole of next week!
I have a feeling this is going to be a chore to sort out.

[ahpook]

Hope you get an appointment soon.

[hiram.k.hackenbacker]

[quote name='ahpook' timestamp='1461343794' post='3033918']
Hope you get an appointment soon.
[/quote]
I would settle for an appointment any time!
Apparently I have to ring every morning to see if an appointments magically open up.

[ivansc]

Ouch on the thumb op, Nancy....
As far as appointments for the surgery, I wound up getting an "emergency" aPPOINTMENT IN fEBRUARY FOR (WAIT FOR IT) THE SECOND WEEK IN nOVEMBER.
i PAID THE SURGEON FOR A PRIVATE CONSULT AND WAS IN WITHIN THE WEEK.
Bugger. Combination of arthritis and not being able to look anywhere but at the keyboard when typing. Sorry!

[NancyJohnson]

I just found some photos of when I had the second one done. I also had a lump cut out of my left forearm hence the big foamy support. There's also a very grizzly one (detailing my forearm bruisng - the consultant wanted to know if any bruising had come out) taken a few days after if anyone wants to yack up their breakfast.
P

Before:


After (blue matches my eyes):

Edited April 24, 2016 by NancyJohnson

[hiram.k.hackenbacker]

I tried ringing the surgery this morning to be told that there weren't any appointments today. I had a bit of a rant and the GP has just rung me back.

Despite not having seen me, it seems that she is quite firmly of the view that injections are the way to deal with this. I have made my representations based on what I have read from NJ and elsewhere and she has given me an appointment for tomorrow at 5pm.

NJ - would I be correct in saying that from the picture above you had a general anaesthetic? If so, was that purely because of the other issue with your arm? I read the page you linked above which indicates the procedure for Trigger Finger is generally done under a local anaesthetic. Is that how you had the others fixed?

[NancyJohnson]

[quote name='hiram.k.hackenbacker' timestamp='1461583797' post='3035799']
NJ - would I be correct in saying that from the picture above you had a general anaesthetic? If so, was that purely because of the other issue with your arm? I read the page you linked above which indicates the procedure for Trigger Finger is generally done under a local anaesthetic. Is that how you had the others fixed?
[/quote]

Nope it was done under a local - they've all been local anaesthetic. The thing they dug out of my arm was a circular mass about an inch in diameter, it was done the at the same time.

Seriously though, insist STRONGLY on the operation. I was referred to a health centre for the last one and the doctor I saw pretty much said, 'I'll give you a cortizone injection and that will sort it out.' She was actually saying this as she made her way to a locked cabinet to get the syringe out! I declined this immediately insisting the cortizone shot would only prove to be a temporary relief and that I didn't wish to go through the whole rigmarole again when the shot wore off and the symptoms returned in a few weeks time, plus, I had previous experience.

Paul

[hiram.k.hackenbacker]

[quote name='NancyJohnson' timestamp='1461586946' post='3035841']
Nope it was done under a local - they've all been local anaesthetic. The thing they dug out of my arm was a circular mass about an inch in diameter, it was done the at the same time.

Seriously though, insist STRONGLY on the operation. I was referred to a health centre for the last one and the doctor I saw pretty much said, 'I'll give you a cortizone injection and that will sort it out.' She was actually saying this as she made her way to a locked cabinet to get the syringe out! I declined this immediately insisting the cortizone shot would only prove to be a temporary relief and that I didn't wish to go through the whole rigmarole again when the shot wore off and the symptoms returned in a few weeks time, plus, I had previous experience.

Paul
[/quote]
Paul,

Thanks for the advice. I could almost hear her tapping away on her keyboard as I was describing my symptoms, then "Right, the first option would be a splint" - cue sense of humour failure. We then moved onto injections. Thing is I need to tread carefully as I would like to get referred by them.

[ivansc]

In my experience the problem is simply that the specialists available on the NHS just simply don't understand WHY the problem is such a big deal for a musician.

I was asked why, if I could straighten the fingers out with the other hand, I didnt just "do that" and carry on playing!

Between that and the two friends who had been butchered by this idiot I am so glad I decided NOT to let him operate on me.

[NancyJohnson]

I don't think it's a
[quote name='ivansc' timestamp='1461603443' post='3036068']
In my experience the problem is simply that the specialists available on the NHS just simply don't understand WHY the problem is such a big deal for a musician.

I was asked why, if I could straighten the fingers out with the other hand, I didnt just "do that" and carry on playing!

Between that and the two friends who had been butchered by this idiot I am so glad I decided NOT to let him operate on me.
[/quote]

I don't know that it's a specifically a musician issue or whether there's an element of trolling here. Ten times worse [i]and [/i]kidney failure?

If your fingers trigger, it's an issue period, doesn't matter whether you play guitar, golf, paint or use your hands for work, you can get it fixed in under ten minutes. It's 2016, it can be treated successfully with a [b]very [/b]minor operation and I can't really see how a qualified orthopedic surgeon would be [i]butchering [/i]anyone, especially as the cut in the palm of your hand is barely 5mm deep, about a centimeter and a half wide and requires two or three stitches. Frankly, I've done far worse stripping mains cable back with a Stanley knife and sharpening kitchen knives in the past.

The guy who did mine was pretty implicit that the surgery was the only 100% cure for the condition and as a consequence I've had four procedures with maybe another one when my pinkie gets worse; I've explained that the condition is caused by inward/outward growth of the A1 pulley and resting up isn't going to make the growth shrink back. It will not resolve itself on its own.

[hiram.k.hackenbacker]

Paul,

Did any of your fingers lock in the hand closed position or were they all still triggering as you opened your hand?

My finger is fairly solidly locked shut today and I don't know why it should suddenly be this bad after so many months. I would normally pull it straight, but it seriously feels like something might give way if I do. Some of the bits I've read do mention that advanced TF can end up with the finger in the locked position. I guess I just need someone who knows what they're doing to look at it. I'm not hopeful that will necessarily happen tomorrow, but at least I will be taking the first step towards resolution.

[MoonBassAlpha]

I've had cortisone injection which took about 6 weeks to clear the triggering, and lasted about 4 years.I had it done in hospital, and it hurt like help having it done.
When it came back, I put off seeing the doctor, knowing what I was in for. Eventually, I got it done by my g.p. and it hurt a lot less, he used a smaller needle, I think, but it is back again after probably 2 years.
Also, I was given a slightly different explanation of my condition to the one above, that the growth was on the tendon rather than the pulley, and it is this that snags in the pulley. Same effect but not exactly how NJ described his.