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Update on hand problem

L

LBS-bass

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Nov 22, 2017
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#1
I posted a thread a little bit back about stepping away from the keyboard, in part because of a hand problem I had been having.

Had an appointment with orthopedics today and the news is not as good as I had hoped, but it isn't horrible. Apparently the surgery is not as noninvasive as I was led to believe by others who have had it done, and the down time from that is roughly 6 weeks before I'd likely have the strength to play again. I can't figure out how I'm going to carve out six weeks from my playing life, so there's a problem unless I want to go back to my earlier thoughts about backing out of my current live music commitments for good.

The other option, which is usually recommended first, is a steroid injection to decrease inflammation. There's apparently a 65% chance that it cures the problem permanently without requiring surgery. Not ideal odds, but considering the down time, going straight to surgery doesn't seem as appealing. My choice, but I'm going to go ahead and schedule the injection and hope for the best.

I would much rather have the surgery and just get it dealt with for sure, but I don't think that's practical any time soon and I need this fixed ASAP. So there we are.
 
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#6
LBS-bass said:
My friend who had the injections told me they were extremely painful. I'd much rather not.
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Well, a cortisone shot is painful by default in my experience regardless of where in the body it gets administered.

Having said that, I can't imagine any type of surgery that would be less painful.

The shots have worked for me in the past and I'd recommend them. Obviously, a *huge* YMMV applies here.

Good luck.
 
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#8
I think the shot is painful because they inject you in your palm about an inch below the spot that's between your middle and ring fingers. There's not a lot of cushion there and it's a sensitive area. But I haven't had it yet so maybe it's much ado about nothing. The only other steroid shot I recall ever having was when I had a massive allergic reaction to a med I had taken and was covered in hives; they put that shot in my butt cheek and I don't recall that one being bad, but I was desperate for relief at that point.

Hopefully they get in touch to schedule it soon.
 
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#11
LBS-bass said:
Trigger finger - Diagnosis and treatment - Mayo Clinic

I was hoping for the "percutaneous release" option rather than the open surgery, but apparently they didn't want to go there. My friend who had the injections told me they were extremely painful. I'd much rather not.
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Hi LBS-bass. I have also suffered from trigger finger in the past. I think the first time was about 4 years ago.

I have not had to get the surgery. I might have to at some point, but the injections did the trick for me for quite awhile. The ortho hand specialist was awesome. The injection was NOT painful. He put a towel on my lap, then sprayed some type of liquid onto my hand where the shot would be given. It was ICE COLD!!! I'm not sure what it was, but you might ask the ortho doc. They would probably know what we're referring to. But it totally numbed it long enough so that the injection was not painful at all. And it did the trick. I was fine for about 2 more years. Edit: This was the steroid injections though - not the "percutaneous release" option.

Then it acted up again. I went back fully expecting him to say I need the surgery. But he said, "Let's try another injection before jumping into the surgery." So far, it hasn't acted up again since.

So bottom line, I'd definitely give the injections a try unless the doc says that your case is so severe that he/she feels surgery is your only option. Short of that though, I'd almost always recommend against surgery if another option might help. If I recall, he told me I could go back to playing my bass the day after the injection. Here's hoping you'll have a good result from the shot like I did...
 
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#12
Jeff K said:
Hi LBS-bass. I have also suffered from trigger finger in the past. I think the first time was about 4 years ago.

I have not had to get the surgery. I might have to at some point, but the injections did the trick for me for quite awhile. The ortho hand specialist was awesome. The injection was NOT painful. He put a towel on my lap, then sprayed some type of liquid onto my hand where the shot would be given. It was ICE COLD!!! I'm not sure what it was, but you might ask the ortho doc. They would probably know what we're referring to. But it totally numbed it long enough so that the injection was not painful at all. And it did the trick. I was fine for about 2 more years. Edit: This was the steroid injections though - not the "percutaneous release" option.

Then it acted up again. I went back fully expecting him to say I need the surgery. But he said, "Let's try another injection before jumping into the surgery." So far, it hasn't acted up again since.

So bottom line, I'd definitely give the injections a try unless the doc says that your case is so severe that he/she feels surgery is your only option. Short of that though, I'd almost always recommend against surgery if another option might help. If I recall, he told me I could go back to playing my bass the day after the injection. Here's hoping you'll have a good result from the shot like I did...
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Thank you. That's reassuring :)
 
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#13
My mother had surgery for that. They just made a very small incision at the base of the finger and released the "sticking" tendon sheath. She was just fine after that. Minimal pain and full recovery.

Personally, I'm against steroid injections. They're usually just a temporary fix and most doctors I talked with both concerning my problem (totally different, cervical disc herniation) as well as other cases (I'm a nurse) wouldn't even discuss it.

I'd suggest you avoid the steroid injection and have the surgery and be done with it once and for all.
 
#16
LBS-bass said:
Trigger finger - Diagnosis and treatment - Mayo Clinic

I was hoping for the "percutaneous release" option rather than the open surgery, but apparently they didn't want to go there. My friend who had the injections told me they were extremely painful. I'd much rather not.
Click to expand...
It IS painful, but it worked for me. I had trigger finger in my left hand thumb. Got the shot in 1999. No problems since then.

Gothic said:
...I'm against steroid injections. They're usually just a temporary fix and most doctors I talked with both concerning my problem (totally different, cervical disc herniation) as well as other cases (I'm a nurse) wouldn't even discuss it.

I'd suggest you avoid the steroid injection and have the surgery and be done with it once and for all.
Click to expand...
Get a new doctor.
 
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#17
51PRI said:
It IS painful, but it worked for me. I had trigger finger in my left hand thumb. Got the shot in 1999. No problems since then.


Get a new doctor.
Click to expand...

Consensus avoids steroid injections. Especially when it comes to the spine. As for the hand, the surgery is minimally invasive and gets rid of the problem.

In any case, hope you get better soon OP, whatever you choose.
 
#18
Gothic said:
Consensus avoids steroid injections. Especially when it comes to the spine. As for the hand, the surgery is minimally invasive and gets rid of the problem.

In any case, hope you get better soon OP, whatever you choose.
Click to expand...
The surgery you had sounds like the percutaneous release, which wasn't offered to me. My option is either injection or fully open surgery with a six-week recovery. Not sure why the percutaneous release was not offered as it is what I had hoped to do.
 
#19
LBS-bass said:
The surgery you had sounds like the percutaneous release, which wasn't offered to me. My option is either injection or fully open surgery with a six-week recovery. Not sure why the percutaneous release was not offered as it is what I had hoped to do.
Click to expand...

It was my mother, by the way but no, it was open surgery. It's just a small incision at the spot where they need to release your flexor tendon (usually it's a spot a bit lower than the base of the affected digit). I've been present in a few of those, both percutaneous as well as "open". The percutaneous kind can be done in a multitude of ways and tools and it's usually for less complicated cases or when the surgeon doesn't really need to intervene with the sheath (pulley).

In cases where there is pain for prolonged periods and worsening of the symptoms, the open kind is recommended. Statistics do show that steroid injections can alleviate the symptoms but that's not always the best course of action. Corticosteroids are anti-inflammatory meds that sometimes just mask the problem while it's getting worse, to the point where surgery might be unavoidable. Hence why a majority of the surgeons I've worked and spoken with prefer to opt for surgery instead. Not to mention that they have their drawbacks as well, vis-a-vis nutrition, drug interactions, etc.

In any case, the "open" kind isn't really that "open". The incision is quite small, it's virtually bloodless (seen it done with a tourniquet on the forearm), you don't even need general anesthesia or an IV and it's quite quick. Granted, there is a prolonged recovery period but that's to be expected.

In any case, trusting your doctor's best, whatever us strangers say on a forum. Again, I wish you a speedy resolution.
 

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