The Wrong Finger
One of the lovely little complications that you can get from having diabetes is stenosing tenosynovitis, affectionately known as “trigger finger”.
What is Trigger Finger?
a common disorder characterized by catching, snapping or locking of the involved finger flexor tendon, associated with dysfunction and pain. A disparity in size between the flexor tendon and the surrounding retinacular pulley system, most commonly at the level of the first annular (A1) pulley, results in difficulty flexing or extending the finger and the “triggering” phenomenon. The label of trigger finger is used because when the finger unlocks, it pops back suddenly, as if releasing a trigger on a gun.
Let me add on:
The pain of trigger finger can become so bad that it wakes you up in the middle of the night. The locking of the finger in a curled position to an open position can make you see stars and clench your teeth and make you lose your breath. The inability to flex the finger renders it useless.
Trigger finger is not one of those items on the list of complications that you learn in your quest to understand what diabetes does to your body. Kidney disease, blindness, cardiovascular issues… they get all the attention. Those get hammered home in all the media and resource information.
Trigger finger isn’t even on the first page. In fact, until the first time it happened to me, I had no idea it was a complication at all.
Ain’t My First Time At This Rodeo
About ten years ago, I got “hitchhiker’s thumb”, which is trigger finger… except it was… yeah. My thumb. Both of them at the same time. (Long story. You can read it here.)
After The Kid was born, it was my index fingers. Both of them. Repetitive motion can trigger (sorry for the overuse of the word) trigger finger, and I was changing a lot of diapers. By the time I dragged myself to the orthopedic surgeon, I couldn’t change a diaper or move them much at all.
Well, it’s back. Just one finger this time. My ring finger on my right hand. And it’s the wrong finger. (I’d much prefer not to have it at all, so any finger is the wrong finger.)
How Do You Fix Trigger Finger?
First line of defense that many people try is: NSAIDS (anti-inflammatory meds), splinting, and steroid injections into the tendon.
While for non-diabetics, the injections of steroids can help and make this issue go away, it’s not a successful course of action. Surgery is recommended to most people with diabetes: percutaneous release or open release. (The first is done via a needle inserted without cutting open the hand.) Open release surgery has been my only option, where the surgeon opens up the sheath surrounding the tendon and as it was explained to me: “the gunk gets cleaned out so that the tendon can smoothly move back and forth”.
So, right now, I’m splinting it and taking NSAIDS. I’ll most likely have surgery as soon as I find one I trust in the area (I moved last year…).
In the meantime, my typing is slow and a little very painful and I am apologizing to John about the level of cleanliness in the house. Unloading the dishwasher is a joke that isn’t funny. I can’t cut my own meat. My right hand is becoming less useful. I am having problems typing, which is why I haven’t written a blog post recently.
This has happened over the last few weeks. No warning. But I know the ending. And that it will most likely happen to other fingers in the future.
I’m hoping next time it’s one of my middle fingers. Because that’s what I want to give this complication.
Ouch.
Oh no, Christel! I’m so sorry!! It sounds awful… 🙁 Thinking of you…
So sorry to hear about this. Too bad you’re not here; I know a great orthopaedist (is that right?). Hope the splint and the NSAIDS give you some relief.
Great post – and you are right! It is a complication – and it is painful – and the good news is that is it relatively easily fixed. I have had both thumbs done and twenty years later one index finger. 40 years with type one and three trigger fingers. better than the “better known” complications! Get in there and get the surgery – no use delaying. Thanks for all you do for the diabetes community and keeping it real . . .
I just had my 8th trigger release, nine fingers done, 2 at once the first time. The way I look at it, only one more to go! Hey after 50 years it’s my only side effect, so I am very, very thankful!!!
Ugh! Yes, I was just diagnosed with T1 (lada) a few years ago, and already got my first two trigger fingers earlier this year. Thumb on one hand, pinky on another. It started with just mild catching and I thought, huh, that’s weird. I could not believe how painful it became (and I’d never properly appreciated my thumbs before and how necessary they are for everything). I had the release surgery finally, and assume I’ll have to have it again in the future on other fingers. Fortunately, it’s a fast and easy surgery and pretty painless so if anyone with symptoms is reading this is freaking out, don’t. Find a good hand clinic–it’s very routine for them and the recovery is easy. You basically have full use of your hands as soon as you can take the bandages off.
So sorry you’re having to go through it again, Christel, but thanks for blogging about it! I didn’t know it was related to the D either when I first started to have symptoms.
I’m so sorry to hear you’re going through this. Again.
I did not know you could get trigger finger by being a diabetic. I’ve had trigger finger at least twice in the past 8 years and I had steroid injections both times which took care of the problem. Yea my BSs were a little messed up, but I DO NOT want to have surgery. I’m a medical transcriptionist and that would mean no worky work. It’s funny neither doc I went to said anything about trigger finger being a complication of diabetes. Hmmmmmmmmmm. Now my problem is I am losing my hearing in one ear. I just learned that is a complication of diabetes. Weird. Enjoy your blog!