The patient is thrilled that she was able to treat her trigger finger without missing any days of work, and without surgery and the recovery process therein.
Trigger Finger is a condition otherwise known as stenosing tenosynovitis, and is characterized by one or more fingers that get locked in the flexed or open position. In order for the affected finger to move, it must be manually forced which can produce a snapping sound as well as a sharp pain. Like Carpal Tunnel, Trigger Finger is a Repetitive Strain Injury. TF is caused by inflammation of the tendons of the fingers’ flexor muscles, or the muscles that bend the fingers into a fist. A tendon can become injured and inflamed with prolonged grasping work which in turn injure, inflame and narrow the surrounding sheath. In serious cases an adhesion or a palpable nodule can develop in the joint area where the finger meets the palm which prevents the tendon from gliding easily through the sheath to facilitate proper movement, and the result is the sticking, popping and pain of TF.
Occupations generally seen with TF are dental hygienists, farmers, machine operators, musicians, and sewers to name a few. People with diabetes or rheumatoid arthritis are also prone to TF. Treatment for trigger finger, depending on the stage and severity, can be ibuprofen, splints and immobility, steroid injections or surgery.
This is of course how trigger finger is explained and treated within the western medical model. From a Traditional Chinese Medical (TCM) standpoint, trigger finger is usually caused by Qi, Blood and cold damp stagnation. I look at pain in this way and determine what underlying pattern has caused the Qi and Blood to stagnate. Most often this involves looking at the body holistically, asking a lot of questions, performing a differential diagnosis using TCM theory, identifying potential deficiencies or excesses that could injure the Qi and Blood in this way and then treating this pattern in addition to the local stagnation. This is how I approached my patient with trigger finger.
My patient is a 55 year old woman who works as a dental hygienist. When she first came to see me in 2013, she had had trigger finger in her right ring finger for six months and her left thumb for two months. She reported that neither finger would bend without pain and sticking, and that if the fingers did bend she had to manually straighten them and the pain doing so was intense. At the affected joints there were palpable nodules which were painful to the touch. Other symptoms included some digestive issues, food sensitivities, and poor sleep. In addition to Qi and blood stagnation I diagnosed her with Spleen Qi deficiency with dampness. I recommended that she come for acupuncture treatments once a week for eight weeks to heal her fingers. I added electrical stimulation to the needles in the affected areas of the fingers. This ensured constant stimulation of the points during the treatment. I also recommended self massage and stretching between her dental patients as she worked.
When the patient came for her second treatment, she reported that her right ring finger was bending and straightening. Although the finger was catching 2-3 times during straightening, she reported that she did not need to help it straighten with her other hand. Her left thumb was still not bending although she reported that it was less sensitive to the touch. She also reports that she is getting better about incorporating massaging and stretching her hands into her routine between patients. Acupuncture treatment on the hands was the same, including electrical stimulation.
After five treatments placing needles around the affected areas and using electrical stimulation, the middle finger was much improved. The patient was able to open and close her right middle finger smoothly and would only feel a catch upon opening if she made a tight fist. The left thumb however was still not bending, although less painful to the touch. After the fifth treatment, the patient did not return for a year and two months.
The patient called me again. She reported happily that after her last appointment with me (she explained that there were some consecutive family crises that prevented her from completing her treatments) she continued massaging and stretching her hands between her dental patients and one month after she stopped coming to me her left thumb started bending and that today both the thumb and the right middle finger were bending and opening smoothly! This was great news but for the fact that despite her stretching and massaging, about 6 months before her right thumb had became afflicted with trigger finger. The right thumb was now achy, sensitive to the touch and would not bend or straighten without help and pain.
So acupuncture treatment resumed with the right thumb. Again, I recommended once a week for eight weeks. She said that this time she would happily comply with the regimen. Needles with electrical stimulation were again placed around the affected area, and also in other areas of the body to treat the underlying pattern. By the fourth treatment, her right thumb was moving with some pain, soreness and morning stiffness. By the seventh treatment, she reports that her right thumb is opening and closing freely with no pain and no morning stiffness! She has experienced a complete recovery from trigger finger in her right thumb, and her left middle finger and thumb are also still functioning with no trouble. In order to maintain the health of her hands and prevent relapse, she makes a special effort to stretch her hands and fingers between her dental patients to the point that she has placed hand written notes around her work area reminding herself to do so. The patient is thrilled that she was able to treat her trigger finger without missing any days of work, and without surgery and the recovery process therein.