Trigger thumb

Several weeks ago, I started noticing that my right thumb was behaving oddly. When I first woke up in the morning, I found it difficult to straighten or bend the thumb. It would flex normally for part of its range of motion, but at about the midpoint I would encounter resistance. If I made a greater effort, the thumb would flex past the point of resistance with an unpleasant (and occasionally audible) pop. Sometimes this would actually hurt. The problem would clear up after I had been awake for an hour or so, but it always came back the next morning.
Eventually, I noticed a couple of additional things. First, the problem did not disappear until after my morning shower. It was responding to heat, as an experiment with a heating pad quickly confirmed. Second, the problem was a little worse each day — flexing my thumb was more difficult and painful until it was heat-treated. I made an appointment with my primary physician for Monday, June 12. I also did a Web search on the terms “thumb”, “bend”, “straighten”, and “pop”, and found numerous pages documenting a disorder called “trigger finger” (or, if a thumb is involved, “trigger thumb”) that sounded exactly like what I was experiencing.
My doctor’s diagnosis was, indeed, that I have trigger thumb. He referred me to the Raleigh Hand Center. The earliest appointment I could obtain was for Friday, June 16. The early-morning impairment continued to get a little worse each day, and — more ominously — the problem started to flare up during the afternoon. I don’t have a heating pad at work, so I would have to get a cup of hot water from the break room, put it on my desk, and dunk my thumb in it for a few minutes.
On Friday, I went to Raleigh Hand Center and was examined by Dr. Post. He confirmed the diagnosis of trigger thumb, and explained that the first thing we should try was a corticosteroid injection into the joint at the base of the thumb, which often cures the problem. (If that didn’t work, an outpatient surgical procedure would be the next step.) I agreed, and he gave me the injection after administering a local anaesthetic. Dr. Post said that improvement might take as long as four weeks to appear, but that most patients noticed the benefits of the injection after one or two weeks.
The thumb was sore for a couple of days after the injection, but now feels fine. I phoned my father yesterday to wish him a happy Father’s Day, and in the course of the conversation we traded stories about our recent medical developments. Dad astonished me by revealing that he has trigger finger in the middle fingers of both hands. His doctor gave him steroid injections, which cured them problem for a while. But it gradually returned. The doctor decided to repeat the injections, and Dad is symptom-free again. If the cure isn’t permanent this time, Dad will undergo the surgery.
It’s interesting that we both developed the same problem at about the same time. I suppose there might be an inherited predisposition, but the causes of trigger finger are poorly understood and may be environmental. Dad and I both use computers a lot. (Dr. Post speculated that my thumb seizes up during the night because I’m not moving it. If that’s how it works, the afternoon flareups at work probably happened because my right hand was holding a mouse, which involves very little thumb motion.) In any case, we now have something new to talk about. The next time our extended family gathers around a dinner table, Dad and I can bore everyone else by comparing notes on our trigger finger experiences. And of course I can bore the readers of this blog (if any still exist) by writing about my thumb here.

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