Trigger finger issues...

[Limeman]

Not sure this is in the right spot, but here goes...

I have been dealing with trigger finger in my left hand for about a year now - ring finger. Got so bad that is would snap shut during gigs, making it next to impossible to play. Lots of pain. Received a cortisone shot back in January '09 and in about 8 weeks, the condition went away. Well, it is slowly but surely coming back in the same finger to the point now that I am prepared to go back and consider another shot or possibly surgery.

My question is: Has anyone here dealt with trigger finger in their left hand, have you had success in treating it with cortisone shots alone, or have you had to seek surgery for a lasting cure? If yes to surgery, what can I expect and what can I do post-op to ensure that my hand functions as normal - exercises, therapy, etc..

Any help or thoughts on this subject would be greatly appreciated.

Cheers!

[Fergie Fulton]

Hi Limeman, sorry your hear about your problem. Surgery is a last course and is successfull in most cases. As you have not responded to previous treatments are you diabetic, and if so how do you control your diabeties?
I will not bore you with information you already know, but Trigger Finger is not always an over-use injury that forms the node. So was it diagnosed as an over-use injury?

[Roonz]

I had this problem once. A cortisone shot cleared it up. I think I was practicing too much. If that's a sin, then I'm going to hell for sure. But, I was not about to go through all that pain again.

I suggest that you keep the action as low as possible on your bass, and also check your technique. I come from a violin background, where my left hand was never parallel to the neck. This technique is not suitable for guitars! The staid advice for left hand technique for guitars is to keep your thumb well under the neck, and keep your palm from touching the neck. Curl your fingers over the fingerboard and hit the strings with the tips of your fingers --'lightly'-- with as little pressure as necessary. The only problem I found with this technique is that the strings continue to ring if you don't stop the note some how, and this causes dissonance and muffled tones if you don't let up on the last note played. The correction to the problem is 'tapping' the fretted notes with the left hand fingers just long enough to sound the note. This works out pretty good. Try it.

Roonz

[Limeman]

Originally Posted by Fergie Fulton

Hi Limeman, sorry your hear about your problem. Surgery is a last course and is successfull in most cases. As you have not responded to previous treatments are you diabetic, and if so how do you control your diabeties?
I will not bore you with information you already know, but Trigger Finger is not always an over-use injury that forms the node. So was it diagnosed as an over-use injury?

Fergie - thanks for the reply. Yes, I am indeed an insulin dependent diabetic (going on 33 years now) but have been blessed to, and have worked extremely hard to have good control, with no eye, kidney or nerve issues and my typical A1C averages between 5.1 to 5.5.

Having said that, the doctors at Kaiser have failed to determine if this is related to diabetes or over-use. They just know I have it. My issue is that if I have yet one more cortisone shot, am I not just postponing the inevitable surgery? I was told that recovery time for the operation is between 4-6 weeks, about the same amount of time it took the first cortisone shot to have any effect. I want the trigger finger gone - so wouldn't it just make more sense to just have the surgery? I'll have to ask my doctor next Monday when I have my appointment about the pro/cons. All I know is I just want my hand healthy so I can get back to gigging regularly.

[Rattman]

Originally Posted by Limeman

Not sure this is in the right spot, but here goes...

I have been dealing with trigger finger in my left hand for about a year now - ring finger. Got so bad that is would snap shut during gigs, making it next to impossible to play. Lots of pain. Received a cortisone shot back in January '09 and in about 8 weeks, the condition went away. Well, it is slowly but surely coming back in the same finger to the point now that I am prepared to go back and consider another shot or possibly surgery.

My question is: Has anyone here dealt with trigger finger in their left hand, have you had success in treating it with cortisone shots alone, or have you had to seek surgery for a lasting cure? If yes to surgery, what can I expect and what can I do post-op to ensure that my hand functions as normal - exercises, therapy, etc..

Any help or thoughts on this subject would be greatly appreciated.

Cheers!

Hey, really sorry to hear about your condition... I have that in BOTH hands. I've already taken one cortisone injection just two weeks ago in the right hand.. We'll see if the left hand gets any worse. I'm really hoping those injections will be 'good enough' for both of us, as the surgery for this condition is kinda "iffy" (the V.A. hospital reluctant to do that procedure, but it will if cortisone fails to remedy the situation). I sure hope your 2nd injection will fix your hand up permanently...

[agreatheight]

I have had trigger finger and I can tell you it is no joke. I am type 2 diabetic and the trigger finger was the issue that got me diagnosed, actually. It was in my left hand, pointer finger. A single shot of cortisone fixed me up - I was feeling relief by the time I got to the parking lot, and I was back to normal a few days later. That was in March I haven't had an issue since. But the doc said that many people need repeat treatment. He actually scheduled me a follow up at the end of that appointment and told me to cancel if things cleared up. So definitely get back with the doc and chat it over with him/her.

Best of luck!

[agreatheight]

Oh, and I should mention that my understanding of the surgery is the same as Rattman's - my doctor wasn't very enthusiastic about it. It seemed very hit or miss. Let us know how it goes!

[Fergie Fulton]

Originally Posted by Rattman

Hey, really sorry to hear about your condition... I have that in BOTH hands. I've already taken one cortisone injection just two weeks ago in the right hand.. We'll see if the left hand gets any worse. I'm really hoping those injections will be 'good enough' for both of us, as the surgery for this condition is kinda "iffy" (the V.A. hospital reluctant to do that procedure, but it will if cortisone fails to remedy the situation). I sure hope your 2nd injection will fix your hand up permanently...

Hi Limeman, glad to hear you have great control over your diabetes. As you know trigger finger and diabetes are connected but, it is still not clear how and why exactly, that is why the cortizone has failed or had limited success so far. Surgery is always a last resort by any good doctor or hospital, as it shows(to me anyway) that they are not just making presumptions about a condition. As with the cortisone it is the loss of glycemic control they will be worried about.

There are good reports on "Short Needling" or "Dry Pricking" as an alternative for diabetics as it is none intrusive. I have no data as such, but the information i am collecting is encouraging in most of the cases. That may be that just the successfull ones are reported and all the failures aren't. LOL

Heres one link from the British Medical Journal about it maybe you can search out more;

http://www.bmj.com/cgi/eletters/331/7507/30#111325

Your doctors have good control of your condition so that should relieve any anxiaty you have about this condition. I have no experience of of what you are going through, though i have delt with some people after such conditions and there has been no problems in my experience with recoveries, so can only offer advice not qualified medical opinion. Trust your doctors, and find a way to use your hands better when this is over.

[Limeman]

Fergie - Yes, the cortisone did elevate my glucose levels for several days. I just kept a very watchful eye on it and checked my blood sugar often and injected additional insulin as necessary to manage. More than that though, it just plain made me feel lousy.

That is interesting that you bring up the acupuncture option. I was looking into this late last year as a possible alternate to the first cortisone shot I ended up taking in Jan '09. My local acupuncturist felt confident he could help heal the trigger but was very reluctant to do it because he was not able to numb my hard and was concerned the pain would be too great. A needle is a needle, and the first cortisone shot hurt plenty enough. I'm willing to try an acupuncture needle for a possible alternate solution and will speak with him about it again.

I will definitely keep the thread updated and thanks again for your insight on this subject.

Cheers!

[Limeman]

Originally Posted by agreatheight

Oh, and I should mention that my understanding of the surgery is the same as Rattman's - my doctor wasn't very enthusiastic about it. It seemed very hit or miss. Let us know how it goes!

Agreatheight,

Thanks for the kind words and advice. I will indeed keep everyone updated. Hopefully by doing so we can help others who have to deal with this!

Cheers!

[TomB]

I have had this condition (related to tendons, I think) in the middle finger of my left hand. I have had cortisone shots twice, and each time they were effective. My doctor was willing to consider an additional shot should the problem recur, but warned that thinning (I think of the tendon, not sure) and the potential for greater harm could result, as with any steroid, and she would be unwilling to go beyond 3 cortisone treatments.

After the 2nd shot she put me on an anti-inflammatory called Meloxicam, as we suspected the problem may be related to RA in my case (I am not diabetic). It has proven effective so far.

Good luck, and let us know if you decide on surgery.