Recovery: Insights on Ligament Healing and Trigger Finger - Rehabilitation

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Hello Doctor: I previously consulted you about my hand issues (carpal tunnel syndrome and trigger finger) and ankle sprains.
Your response was very satisfactory.
However, I came across some content on this website that made me question: when I had my ankle sprain, an ultrasound examination revealed that two ligaments were completely torn.
I did not undergo surgery and only went through rehabilitation.
Now, I can walk and move without pain.
Do ligaments regenerate on their own?
Regarding my hand issues: 1.
After rehabilitation, it seems that my carpal tunnel syndrome has improved!? I also use a new pillow while sleeping, trying not to put pressure on my hands or wrists, and even when I wake up on my side, I don't press on my hands! I only experience slight numbness and pain in my wrist when using my phone or leaning on the table! Personally, I am unsure if I have fully recovered?! 2.
The only persistent issue is the trigger finger! My ring finger is difficult to straighten when bent, and straightening it causes pain, especially near the junction of the ring finger and palm! So, I usually keep it bent.
However, if I accidentally straighten it while working, it becomes very painful! The effects of rehabilitation have been very limited and very slow! My rehabilitation physician has prescribed medication and provided rehabilitation orders along with a splint.
I have also researched online, and given my situation, it seems that the options are either steroid injections or surgery! But I am terrified! I fear the consequences of steroid injections...! The rehabilitation physician also mentioned that if this round of rehabilitation does not yield results, I would need to return for an injection! He mentioned another method involving steroid injections, but I forgot the name; he lacks clinical experience in that area.
He said that only a specific hospital has clinical experience with that method, and I truly don't know what to do! Regardless, I need to rest for a few days! Steroid injections require a 7-day rest, but I am unsure how many days of rest are needed after surgery? Currently, I work as a cleaner and frequently use my hands every day! If I choose minimally invasive surgery, I am also worried about the costs and whether it will actually heal! What if it doesn't work and I undergo surgery for nothing!? I greatly appreciate your response, thank you very much!

Jason, 30~39 year old female. Ask Date: 2019/04/01

Dr. Yin Xinbei reply Rehabilitation


Ankle issues: If there is a complete rupture, it will not heal on its own and can only be compensated by other tendons or ligaments.
Hand problems: 1.
It only provides temporary relief.
2.
Frequent use of corticosteroids can lead to side effects; even if surgery is required, it is typically a minor procedure and should not be overly concerning.
The number of days for postoperative rest should be discussed with the surgeon.
Since your job involves frequent use of your hands, rehabilitation may not be sufficient in a timely manner, so please consider further treatment options.

Reply Date: 2019/04/01

More Info


When it comes to recovery from ligament injuries and conditions like trigger finger, it's essential to understand the healing process and the options available for treatment. Based on your concerns, let's break down the issues you're facing and explore potential solutions.


Ligament Healing
Ligaments are tough bands of connective tissue that connect bones to each other at joints. When ligaments are torn, as in your case with the ankle injury, they can heal on their own, but the process can take time. The body has a remarkable ability to repair itself, and in many cases, non-surgical treatments such as physical therapy can help restore function and strength.
In your situation, since you mentioned that you are now able to walk and move without pain, it suggests that your ligaments may have healed sufficiently. However, it's important to note that while the pain may have subsided, the ligaments might not have returned to their original strength or elasticity. Regular follow-up with your healthcare provider is crucial to monitor the healing process and ensure that you are not at risk for re-injury.


Carpal Tunnel Syndrome and Trigger Finger
Regarding your wrist and hand issues, it sounds like you have made significant progress with your carpal tunnel syndrome, especially if you are experiencing less pain and discomfort. The use of a new pillow to avoid pressure on your wrist is a good strategy, as proper positioning can help alleviate symptoms. However, it’s essential to continue monitoring your symptoms and maintain communication with your healthcare provider to ensure that your condition remains stable.

As for the trigger finger, this condition occurs when the tendons that bend the fingers become inflamed, leading to difficulty in straightening the affected finger. The pain and stiffness you describe, particularly near the base of the finger, are common symptoms.

Treatment Options
1. Conservative Management: Since you have already undergone physical therapy, it's worth discussing the effectiveness of your current regimen with your therapist. They may suggest additional exercises or modifications to your routine that could help improve your symptoms.

2. Corticosteroid Injections: Your concern about corticosteroid injections is valid. While these injections can provide significant relief by reducing inflammation, they do come with potential side effects. It's crucial to have a thorough discussion with your healthcare provider about the risks and benefits, especially considering your work as a cleaner, which requires frequent use of your hands.

3. Surgery: If conservative treatments fail, surgery may be considered. The procedure for trigger finger is typically minimally invasive and involves releasing the constricted tendon sheath. Recovery time can vary, but many patients return to normal activities within a few weeks. Discussing the specifics of the surgery, including recovery time and potential outcomes, with your surgeon can help alleviate some of your concerns.

4. Alternative Treatments: Some patients find relief through alternative therapies such as acupuncture or splinting. These methods can sometimes provide additional support during the healing process.


Conclusion
In summary, while your ligament injuries appear to be healing well, ongoing monitoring and management of your hand conditions are essential. It’s understandable to feel apprehensive about injections or surgery, but having open discussions with your healthcare provider can help you make informed decisions. Remember, the goal is to restore function and minimize pain, allowing you to continue your daily activities without discomfort. Always prioritize communication with your healthcare team to ensure the best possible outcomes for your recovery.

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