"Trigger" Finger - Not a Gun Thread

[j44ke]

Not to overshare here, but for some reason, I've been sleeping with each of my hands balled up in a fist. The result is that the middle knuckle on every finger (except 2x pinky finger) sticks - either opening or closing my hand - when I wake up in the morning. Not permanently, just act as if there is an indent that I have to "click" past to move my fingers. After a very few stretches and flexing of my fingers, it seems to relax and go away. If I think about it before going to bed, I can keep my hands generally open and then no issues. But if I am really worn out and just kind of collapse, I wake up with balky finger joints.

I work with my hands almost every day, either string trimmer or chainsaw or rake or shovel or weeding hand-hoe. I've got pains and stiffness in any number of different places on my body, so I don't know why I would think that my hands would be immune.

Is this something others have experienced? Other than stretching, what should I be doing? I've got a couple trigger finger splints that are supposed to be worn at night that I am going to try out, but that seems more like treating the symptoms than doing anything that will repair or recondition the joints. Or the tendons, which seems more likely to be the issue here.

[Dave Thompson]

It sounds like you’re getting muscle cramps when your hand makes a fist. I get them sometimes too and all I can do is flex the fingers, usually manually with my other hand.

Maybe before you go to bed do some sort of finger dexterity exercises along with stretching.

[Mabouya]

Seems to be relatively common, at least according to these folks:

https://jaxsleepcenter.com/why-do-i-...hile-sleeping/

[j44ke]

Definitely the cramping thing. That's what my hands feel like in the morning. I have an elastic egg I was prescribed for strengthening muscles around my thumb joint so maybe I'll run through the exercises with that before bed. Also physical exertion and back ache. Currently working on a stubborn muscle strain in my lower left back/hip from overuse, trying to get that loosened up. I guess I'll keep working on that too.

Hopefully my hands don't attack me in the middle of the night meanwhile.

[72gmc]

I'm currently in PT for trigger finger in 2 fingers. I sleep with splints my therapist made that stop at the first knuckle. I even wear them during the day, including right now. I apply heat and do the exercises my therapist recommends.

One of my fingers got pretty bad before I sought treatment. It would wake me up at night, aching. I'm not sure if it will ever get better without surgery, but I'm trying to get better at managing it and avoiding surgery. I am conscious of keeping a loose grip when holding or carrying things (enough but not too much) and of using my whole hand instead of just my fingers. I fear a midlife crisis involving rock climbing is not in the cards.

So, I'd say talk to your doc and perhaps give yourself something to grip while you sleep. Insert jokes here.

[giordana93]

definitely do everything you can to reduce the inflammation and avoid building up the scar tissue which causes this, including, if necessary, getting the shot (hurts like a mofo). I developed trigger finger in right middle finger and eventually had to have the surgery to "release" it--basically cutting the pulley through which the tendon passes. Your tendon gets inflammed and sticks as it passes through the pulley(s). Ice, rest, and nsaids are more effective than stretching. Give your hands a break until symptoms resolve if possible.

[giordana93]

I've got a couple trigger finger splints that are supposed to be worn at night that I am going to try out, but that seems more like treating the symptoms than doing anything that will repair or recondition the joints. Or the tendons, which seems more likely to be the issue here.

use the splints because the condition is the symptom, if that makes sense. In other words, it's the thickened section of the tendon passing through the pulley that is the cause of the click and the click is the cause of the further thickening. Inflammation is the enemy, not muscle fatigue or lack of flexibility.

[j44ke]

Good advice all. Thanks. I am doing a bit of stretching evening and morning. Have the splint on the worst finger. This probably sounds weird but concentrating on not clenching my fists before I go to sleep has actually helped. Functions as meditation of a sort I guess.

[one60]

consider this a public service announcement rather than a diagnosis but some of the symptoms suggest early stages of Dupuytren's Contracture.
Here's hoping that can be ruled out.

https://www.physio-pedia.com/Dupuytr...9s_Contracture

[Jamie Medeiros]

Over the years I have had trigger finger - stenosing tenosynovitis on three fingers. It got so bad some fingers couldn't open on their own. Cortisone injections did nothing for me so I ended up having surgery on all three. It is a fast surgery and has fixed the problem.

[j44ke]

Wow - a wealth of info once again at VSalon. It occurs to me that my grandfather (a surgeon) had corrective hand surgery of some sort. I’ll see if my dad can remember what it was.

Thanks!

[SpeedyChix]

I've had surgery on one finger. Others trigger based on inflammation levels and/or activity that irritates them. Best unlock success has been to gently massage the area in the palm of the hand where the sheath/tendon issue is before working to "unfold' the finger from the fingertip, sort of unrolling the finger. It can go easily or painfully. At some point I'll likely need to have three more fingers done. As it gets worse your fingers won't fully straighten.

[bigbill]

I have it on the little finger on my left hand. I see a Rheumatologist for my autoimmune issues and it could be the beginnings of RA symptoms. He checks my joints but so far it's only one finger. He mentioned surgery if it worsens, but so far I can extend it without help.

[NYCfixie]

Wow - a wealth of info once again at VSalon. It occurs to me that my grandfather (a surgeon) had corrective hand surgery of some sort. I’ll see if my dad can remember what it was.

Thanks!

I know (am related to) a very good Rheumatologist and he knows some very good hand surgeons if you get to that place. They are in the city but have Westchester outposts if needed.

I hope you can find a much less invasive cure.

[NorTX-Dave]

I'm a retired US Army Occupational Therapist. I treated all flavors of upper extremity injuries and maladies, including trigger fingers. Over the course of my career, I prescribed custom fabricated splints as described earlier, stretches, massage, ice and heat, OTC anti-inflammatories, rest and in-clinic treatments to include ultrasound and iontophoresis.

In my experience splints and rest really did the most good for the most people since this seems to be an overuse type of injury (given the absence of underlying disease or trauma). There were of course outliers and sometimes massage and ice seemed to help. I'd advise my patients to NOT do additional exercises since the tendon is irritated where it passes under a ligamentous "pulley" or sheath and in my opinion additional motion, especially squeezing exercises that force the tendon to move under load are contra-indicated. Injections seemed to help some people and surgery almost always did the trick.

Trigger fingers can be very recalcitrant, and many times recurring. Good luck!

[monadnocky]

consider this a public service announcement rather than a diagnosis but some of the symptoms suggest early stages of Dupuytren's Contracture.
Here's hoping that can be ruled out.

https://www.physio-pedia.com/Dupuytr...9s_Contracture

I have Dupuytren's. Funny that it's now in the public awareness so much (thanks John Elway!). It's not uncommon and can be anywhere from practically unnoticeable to pretty disabling. Mine's in the former category - I easily pass the "table test" and it's never hindered my riding at all.

My impression is that the "trigger finger" condition is distinct from Dupuytren's.

[j44ke]

I am pretty sure my issues are the direct result from landscaping work - with the chainsaw and with the string trimmer. The string trimmer is probably the primary culprit as it has plenty of torque, enough that it can also be used as a brush cutter with a blade suitable for cutting small saplings. So it requires a consistently firm grip not just to keep the two-part trigger depressed and the machine running but also to offset the machine’s gyroscopic pull.

As a result, I’m only doing 2-3 hours of trimming and not mixing in chainsaw work with the trimmer. Alternating days periodically with day off in between. And then I do some stretches for my hands (table top, spreading fingers, piano key movements and finger stretching/flexing) and hand massage before bed and in the morning. Seems to be helping.

I’m not a good patient. I tend to work until I am exhausted. I realize that’s not the best approach and am trying for more moderation. Giving myself a firm quitting time seems to be helpful.

[72gmc]

Do you wear gloves? I’m guessing my issue was not helped by my lack of discipline about wearing work gloves. I know when I do wear gloves, my hands are less tired because I’m able to grip tools with less pressure.

[j44ke]

Do you wear gloves? I’m guessing my issue was not helped by my lack of discipline about wearing work gloves. I know when I do wear gloves, my hands are less tired because I’m able to grip tools with less pressure.

Yes definitely. I usually wear leather gloves to fend off shrapnel, but if it really hot, I wear a pair of (surprisingly durable) elasticated gloves with grippy latex fingers and palms. The latter is actually better at dealing with vibration but the leather is better protection.