Approximately six weeks after hand and wrist surgery, I developed “trigger finger” in the pinky finger of my surgery hand. After the splints were removed and I started using my fingers again, I noticed my pinky finger “clunked” when I curled it, and it “clunked” upon full extension too.
Trigger finger (medical name: stenosing tenosynovitis) happens when inflammation occurs in the sheath surrounding a finger’s tendon, narrowing the space through which the tendon moves and impinging its movement.
After two weeks of occupational therapy and treatment for the swelling in my hand and wrist (eight weeks post-surgery), the clunking in my finger had gotten worse. So the therapist informed the surgeon, and he decided to treat the trigger finger with a steroid injection. This was not fun.
My orthopedic surgeon cleaned the injection site thoroughly with an alcohol wipe and then he sprayed an icy numbing spray on the area. I felt the needle go in. But the discomfort started as he began to inject the steroid solution. It felt very similar to an arthrogram injection – there is increasing discomfort as the space begins to fill. In the case of an arthrogram contrasting solution injection, your joint fills with fluid. In the case of this steroid injection, my tendon sheath filled with fluid.
As the discomfort increased, I once again found breathing exercises very helpful for controlling the discomfort (for more on breathing exercises, see this previous post). Additionally, my surgeon was applying pressure to the tip of my finger which helped focus my attention away from the discomfort at the injection site near the base of my finger.
About halfway through the process of filling the tendon sheath with the steroid solution there was a noticeable “clunk”. Both the surgeon and I could feel it. He asked me if I felt it, then grinned and said “That’s a good sign. We’re getting the solution where we want it.”
Toward the end of the injection there was a second “clunk”. My surgeon was very pleased. As he continued the injection, he asked if it felt to me like the area was getting too full. When I said no, he finished emptying the syringe, removed the needle, and placed a band-aid over the injection site.
My surgeon warned me that it would probably hurt the next day – possibly a great deal. He mentioned that I might find myself saying very uncomplimentary things about him.
[As it turned out, I had no pain or discomfort the next day. I don’t know if it made a difference that I was wearing a compression glove, a compression stocking, and a brace on that hand.]
My occupational therapist cautioned me not to do my therapeutic exercises for the remainder of the day, as that could cause the steroid solution to work its way out of the target area. She also told me not to apply heat to the area for the remainder of the day, but said that I could ice it as desired.
For several days following the injection, I am supposed to modify my therapeutic exercises to exclude my pinky finger as much as possible. My surgeon said it can take up to five days to achieve the full effect. The steroid injection should reduce the inflammation and allow the affected tendon to move freely again.
I did notice the temporary side effect of facial flushing, but it didn’t last very long (maybe 20-30 minutes). My finger was also swollen and numb after the injection. I’m not sure how long that lasted, because I went home immediately and applied a cold pack to the area. By the time I removed the cold pack, the numbness was gone and most of the swelling was too.
In theory, the steroid injection will relieve the inflammation and cure the trigger finger. Meanwhile, the rest of the post-surgery swelling of the hand and wrist should gradually abate and hopefully the trigger finger condition will not return. In other words, hopefully this one treatment will fix it and I shouldn’t need another steroid injection.
Bottom Line: It was pretty uncomfortable during the injection, but I didn’t experience any after-effects. If this cures my trigger finger in one treatment, it will have been totally worth the temporary discomfort. As far as medical procedures go, for me, this one was no big deal.
Whew. It’s nice to have a medical procedure work as planned– for a change.
I’m also learning a tremendous amount about symptoms & syndromes! I had no idea that “clunks” and other joint noises were more than just an occasional annoyance.
Thanks, Doug! I agree – nice to catch a break.
Yup, turns out a lot of things I thought were just “part of getting old(er)” are actually manifestations of earlier damage/wear and tear. I read an article recently that said development of osteoarthritis prior to age 60 is usually evidence of prior trauma.
When we were young, we thought we were bulletproof. Little did we know those traumas would come back to haunt us later.