Dr. Jessica Hong Wing Lee, DC – Hong Kong Chiropractor

Information and Thoughts About Chiropractic, Health, and the Human Body.


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My finger is stuck!

Recently, a few of my patients have experienced the problem of one of their fingers seemingly stuck then suddenly… unstuck. What’s going on?

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Trigger finger is a condition where your fingers seem stuck when bending or straightening and then suddenly releases and pops back. It is commonly called “trigger finger” because of the similarity to pulling the trigger of a gun. It can involve any finger including the thumb, and may affect more than one finger or more than one hand at a time. The ring finger is the most commonly affected.

Initially, people with trigger finger usually notice soreness at the base of the finger or thumb. Some people report the problem started with a painless clicking when moving the fingers. Finger stiffness is often experienced, especially in the morning, and may occur when firmly grasping an object or when straightening the finger. There may be difficulty in fully straightening or bending the finger. As the condition gets worse, the finger locks in a bent or straight position and often needs to be aided with the other hand. People will commonly say that they feel a painful clicking or popping when bending or straightening the finger. This sensation of the finger getting stuck is worse when not moving for a prolonged period of time but seems to be better with movement. Some people notice a bump at the base of the affected finger. Eventually the finger will not be able to fully bend or straighten and is usually stuck in a contracted position. Over time, due to avoiding the painful triggering, there may be the development of secondary contractures and generalized finger stiffness. Symptoms may be aggravated by hand use at work, home, gardening, and playing sports.

This condition occurs due to irritation of the tendon sheath of the finger. Tendons attach muscle to bone. The muscles that control the movements of the fingers and thumb are located in the forearm above the wrist. These tendons travel from the forearm through the wrist to the small bones of the fingers and thumb. Each tendon is surrounded by a protective tendon sheath and there is a pulley system that keeps the tendon in place next to the bones. When you bend or straighten your finger, the tendon slides through the tendon sheath and pulleys. Due to some reasons such as overuse or injury, the tendons can become irritated and thicken, forming nodules that make its passage through the pulley tunnels more difficult leading to a clicking sensation. When the tendon becomes momentarily stuck at the opening of the tendon sheath tunnel, when you are trying to bend or straighten your finger, then suddenly slips through the tight area is when you may feel a pop and the finger will suddenly shoot straight out or bend. Usually the fingers are stuck in a bent position because the tendons of the finger that control bending are strong enough to overcome the restrictive and narrowed tendon sheath while the tendons that control straightening are not.

Trigger finger reportedly happens more to people whose work or hobbies require repeated and strong gripping actions such as farmers, industrial workers, and musicians. However, studies have not found any definite association between trigger finger and the workplace, so the cause is probably due to multiple factors. The condition tends to be found more in women and those between the ages of 40 to 60. It is more common in individuals who have diabetes, rheumatoid arthritis, renal disease, hypothyroidism, amyloidosis, etc. It may be a complication associated with surgery for carpal tunnel syndrome. Sometimes it can happen after a hand injury. In many cases the condition has no known cause and is insidious.

Trigger finger can be diagnosed with a physical exam of the hand and fingers. Lab tests and x-rays are usually not necessary unless ruling out other differential diagnoses. If you notice that there is stiffness, catching, numbness, or pain in a finger joint or you are unable to straighten or bend a finger then make an appointment with a health professional. You may notice that the finger is swollen or there is a bump over the joint. For self-care at home you may try resting, applying heat, applying ice, stretching, and modifying your activities that involve repeated gripping. Chiropractors may manage this problem with modalities such as ultrasound and/or electric stimulation, Graston, wax therapy, rehabilitation exercises, adjustments, splinting, etc. For chiropractic therapy, the goal is to decrease the swelling and get rid of the locking to allow full, painless movement of the fingers. If these conservative measures don’t work then surgery may need to be considered where the pulley at the base of the finger is cut open to allow the tendon to glide more freely.

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7 Exercises to Try for Trigger Finger:

  • Lay your palm down on a flat surface. Lift each finger one by one and hold in the lifted position for 2 seconds before returning to the original position. You may use your other hand to pull the fingers to increase the tension. Repeat 10 times each finger.

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  • Wrap a rubber band around your fingers. Open and close hand against the resistance. Repeat 20 times each hand.

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  • Touch each finger to your thumb. Repeat for 2 minutes.

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  • Hold a therapy ball in your palm. Squeeze for 5 seconds then release. Repeat 10 times.

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  • Fold your fingers down together joint by joint until you make a fist, then straighten your fingers. Repeat 20 times.

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  • Massage the joint and area affected by the trigger finger for 3 minutes.

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  • Place a towel on a table. Place your palm on the towel. Grab the towel with your fingers and scrunch it while applying pressure on your fist. Maintain this position for 5 seconds then straighten fingers slowly. Repeat 15 times.

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Is the Weather Giving You Pain?

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Ever since I broke my finger in the 8th grade, I have had the ability to sense when it is going to rain or become quite cold.  However, as I got older, I realized that large amounts of people have this ability and that it is not unique.  It is very common for people to blame weather for increased pain in their joints.  We all know someone who say things like “my knees are hurting more than usual today, it must mean that tomorrow is going to rain”.  It is a phenomenon that is most often associated with cities that experience extremely cold weather, but it happens to many people in Hong Kong too possibly due to the humidity and precipitation.  Even in a city like San Diego where the temperature is always mild and never gets too hot or too cold, people report a great sensitivity to weather changes.

 

So what is it that brings on increased joint pain with weather changes?  Currently, there is no full agreement among scientists that weather causes pain, and the exact mechanism is not known, but there are several plausible theories.  Although people blame the cold, wind, rain or snow, research suggests that barometric pressure is what affects people the most.

 

Barometric pressure is the weight of the atmosphere that surrounds us.  Imagine the tissues surrounding the joints to be like a balloon.  Barometric pressure normally pushes against the body from the outside and keeps the tissues from ballooning out or expanding.  Usually before bad weather starts, the barometric pressure of the environment decreases.  Because there is less air pressure pushing against the body, this allows the tissues surrounding the joints to expand and this leads to more pressure on the joints.  If the joints have arthritis already, this increased pressure may lead to more pain.  When people have chronic pain, often the nerves are already more sensitive due to injury, inflammation, adhesions, and scarring.  In these people, even very minor changes in barometric pressure can lead to pain. 

 

Cold weather can affect joint fluid thickness so that there is less lubrication in the joints that leads to more pain.  When the temperature is cold outside, the tissues of the body contract and this pulls on the nerve endings that can lead to increased sensitivity or pain.  So when the barometric pressure drops when it is cold, again there will be less air pressure pushing against the tissues and this inflamed tissue will expand leading to more pain.

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There are many methods to alleviate weather related joint pain.  One of the most effective strategies is to keep active.  Exercise helps to lubricate the joints to prevent pain.  Try some low impact aerobic moves that are easy on the joints such as walking, Yoga, or Tai Chi, which enhances the range of motion.  Stretch in the mornings and evenings to stay flexible and decrease tension.  Swimming in a heated pool can help alleviate back and joint pain.  You can also try applying a heating pad onto your painful joints to let the muscles relax and sooth the joint pain. 

 

As a chiropractor, I have seen first hand how this regular therapy can help these patients.  Many of my patients complain of increased joint pain with poor weather.  After undergoing a treatment plan where the movement of their joints improves significantly, their weather related pain dissipates.  Now these patients no longer have joint pain with damp or cold weather.