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Will I ever be able to bend my thumb again? DR MARTIN SCURR answers your health questions

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Will I ever be able to bend my thumb again? DR MARTIN SCURR answers your health questions

QUESTION: Recently I woke to find that I couldn’t bend my right thumb. My middle finger was slightly swollen, too, and I had restriction in my jaw. The GP said I had trigger finger. Could you advise a cure?

Valerie Horton, Kingsfold, West Sussex.

ANSWER: Trigger finger occurs when the tendon that helps to move or flex the finger catches in the sheath it runs through.

The tendon is a cord-like structure that attaches the muscles to the bone. If the tendon or the sheath in which it runs become inflamed —which may occur through overuse, for example, and those with repetitive gripping actions are at increased risk of this — then there is not enough room for the tendon to glide through and it snags on the sheath.

Trigger finger occurs when the tendon that helps to move or flex the finger catches in the sheath it runs through. (Stock image)

Trigger finger occurs when the tendon that helps to move or flex the finger catches in the sheath it runs through. (Stock image)

This causes a sudden catching sensation and so — as in your experience — the finger locks when bent (known as state of flexion) and you can no longer straighten it.

Curiously, it is normally a painless experience.

This condition affects around two per cent of us at some stage of our lives, and it is most common in older women, though it is unclear why this is the case.

Triggering also occurs more commonly in those with type 2 diabetes, as high blood sugar may encourage inflammation, and in patients with rheumatoid arthritis, an inflammatory disease that affects not only joints, but tendons, too.

Dr Martin Scurr (pictured) examines how trigger finger occurs and what to do if your symptoms become worse

Dr Martin Scurr (pictured) examines how trigger finger occurs and what to do if your symptoms become worse

Typically the thumb, ring or little finger are affected.

I have some concern for you as you say you also have swelling of one middle finger along with restriction of your jaw.

This prompts the question: might a condition be evolving, such as polyarthropathy, which is an inflammatory disorder involving multiple joints?

At this stage, the pattern is not yet typical of anything like that. 

But, if your symptoms become worse, then I would recommend you ask your GP for blood tests to look at, for example, inflammatory markers, including CRP (C-reactive protein), as this may suggest a more generalised inflammatory condition such as rheumatoid arthritis.

The initial treatment of trigger finger or thumb is conservative: splinting for four to eight weeks, to allow the tendon to ‘rest’ and for any inflammation to reduce.

This is supplemented, if necessary, with a regular non-steroidal anti-inflammatory drug, such as ibuprofen, if not contraindicated for other reasons.

The initial treatment of trigger finger or thumb is conservative: splinting for four to eight weeks, to allow the tendon to 'rest' and for any inflammation to reduce. (Stock image)

The initial treatment of trigger finger or thumb is conservative: splinting for four to eight weeks, to allow the tendon to ‘rest’ and for any inflammation to reduce. (Stock image)

Research has shown that splinting leads to an improvement in more than 90 per cent of patients, many of whom experience full resolution as a result. 

The nurse at your practice can show you how to fix up a suitable splint, or a referral to a physiotherapist or occupational therapist can achieve the same end.

If this fails, then a one-off steroid injection mixed with local anaesthetic will bring about long-lasting and significant improvement in most cases.

In my view…a social life nourishes the brain

There is a wealth of data confirming that loneliness can be detrimental to health — and may have as significant a negative effect as a diet deficient in essential nutrients.

Studies suggest that social isolation plus increases in blood pressure and reduced sleep quality in lonely people can both cause depression and worsen it.

Depressive illness is a major risk factor for many aspects of physical health, including heart disease and, if it’s not identified and successfully treated, it leads to an earlier death.

The brain controls most of what happens in the body — and we need social interaction to feed it.

Warm social contact is as vital a nutrient for the brain as iron, zinc and vitamin D are for the body.

Just as salt, sugar and preservatives are no replacement for nourishing foods, neither is online communication nor phone calls a replacement for face-to-face contact and the human touch.

If you’re living alone, socially isolated and lacking human contact, then a voice or a face on a screen is at least something — but it is second best and lacks certain vital ingredients that are hard to define, and even harder to measure.

In essence, it is not real contact.

Social isolation is a powerful risk factor for both illness and death, with the greatest negative consequences among the elderly, the poor and ethnic minorities.

The Covid pandemic has added to the loneliness of many, another reason why the reverberations will continue to spread long and far.

The duty of all of us is, when possible, to take the trouble to return to face-to-face contact and to avoid sliding too easily into the world of online and telephone care.

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