Trigger Finger : The Doctor is In, Dr. Randy Kertz, D.C.
Something that I see commonly in my office, especially among the musician and mechanic populations as well as others who use their hands for fine movements is a condition commonly known as trigger finger. Trigger finger is a condition where a finger, commonly the middle or index, will not straighten properly and will get stuck, to the point where you have to manually straighten it with your other hand. Bending is not a problem. This condition is easily identified by making a fist and seeing which fingers remain behind after releasing the fist.
The condition occurs from constant bending of the fingers in a stressful position, i.e. playing position. Tendons of muscles associated with finger flexion, i.e. bending, pass through tendon sheaths, or coverings, and normally have a smooth gliding movement. A nodule, or bump, can form in the palm on or at the sheath of a finger tendon due to irritation through overuse. The result is that the finger gets stuck in flexion and clicks and stutters as you move the finger to try to straighten it. Force in the form of assistance from the other hand is usually required to straighten the fingers.
Rest, anti-inflammatories, and especially glucosamine sulfate can be very effective in treating this condition. Glucosamine and chondroitin are commonly sold as a supplement called glucosamine sulfate. This supplement creates a water-based molecule, which goes to the cartilaginous areas of the body. This helps to hydrate them and lubricate tendons since they normally don’t receive any or enough hydration. A word about this and other supplements: since they are not regulated by the FDA, as long as they don’t poison you the manufacturers can put anything they want in them and often what is listed on the label does not accurately reflect the contents inside. I’ve had patients use this particular supplement from a manufacturer that I use and sell in my office, while others have gone to the drug store and bought the cheapest stuff they could find, sometimes with good and sometimes not so good results. Sometimes you get more pills with a cheaper brand, but have to take twice as many to get the proper dosage. This supplement is available over the counter and has very few if any side effects, but should still be cleared with your health care professional to make sure it is suitable for you, as with any supplements.
Ultrasound and acupuncture are usually effective for this condition, the idea being to reduce swelling in the area, for which resting the hand and refraining from the offending repetitive activity is also recommended. Tight musculature in the forearm from overuse may also need to be addressed and massaged or worked out. If all other options are exhausted, an epidural injection or surgery, which is rarely recommended, may be considered.
All the best always,
Dr. Randall Kertz is the author or The Bassist’s Guide to Injury Management, Prevention and Better Health – Volumes One & Two. Click here to get your copies today!