Effective Treatment Options for Finger Joint Pain After Injury

Pain at the distal interphalangeal joint of the fingers?

Hello, doctor.
I previously sustained a bruise from external force, initially thinking it was due to eating radishes.
However, after two months of taking anti-inflammatory medication, undergoing rehabilitation, and receiving shockwave therapy, there has been no improvement.
The first orthopedic doctor diagnosed it as a radish-related issue, stating that the bones are fine.
The second orthopedic doctor diagnosed it as a lateral ligament injury.
I would like to ask, now in the 10th week, my middle finger can bend (it can extend upwards, but when bending downwards to a certain degree, there is a cracking sound and pain at the first joint of the middle finger).
I cannot exert force when making a fist, and any effort causes pain.
I work at a beverage shop, where I need to use my fingers.
Do you have any recommended treatment methods? (The previous doctor mentioned that injections and shockwave therapy might not be effective because the issue is quite deep.) Thank you, doctor!

Jiang, 10~19 year old female. Ask Date: 2024/03/29

Dr. Shi Guozheng reply Orthopedics

Injuries to the wrist typically take a longer recovery time, usually over twelve weeks.
Currently, you can continue with rehabilitation or apply heat therapy.
If there is significant pain, you may intermittently take pain relievers to alleviate discomfort.

Reply Date: 2024/03/29

More Info

Injuries to the fingers, particularly those involving the joints, can be quite complex and often require a multifaceted approach to treatment and rehabilitation. Based on your description, it seems you have been dealing with persistent pain and limited functionality in your middle finger for about ten weeks following an injury. Here’s a comprehensive overview of effective treatment options and rehabilitation strategies for finger joint pain after an injury.

Understanding Your Injury
From your account, it appears that you may have sustained a ligament injury, specifically to the collateral ligaments of the finger joints. These ligaments are crucial for stabilizing the joints during movement and gripping activities. The "popping" sound you hear when bending your finger, along with the pain, suggests that there may be some instability or irritation in the joint.

Initial Management
1. Rest and Activity Modification: It’s essential to give your finger adequate rest, especially since your job requires repetitive use of your hands. Try to avoid activities that exacerbate the pain, such as heavy gripping or lifting.

2. Ice Therapy: Applying ice to the affected area can help reduce inflammation and numb the pain. Use ice packs for 15-20 minutes several times a day, especially after activities that cause discomfort.

3. Pain Management: Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help manage pain and reduce inflammation. However, consult with your healthcare provider before continuing any medication long-term.

Rehabilitation Strategies
1. Physical Therapy: Engaging in physical therapy is highly recommended. A physical therapist can design a tailored rehabilitation program that includes:
- Range of Motion Exercises: Gentle stretching and bending exercises can help restore flexibility to the joint. Start with passive movements and gradually progress to active movements as tolerated.

- Strengthening Exercises: Once the pain decreases, strengthening exercises can help stabilize the joint. These may include squeezing a soft ball or using resistance bands.

- Joint Mobilization Techniques: A therapist may use manual techniques to improve joint mobility and reduce stiffness.

2. Therapeutic Modalities: Depending on the therapist's assessment, they may use modalities such as ultrasound therapy, electrical stimulation, or heat therapy to promote healing and alleviate pain.

3. Taping or Splinting: Taping the finger or using a splint can provide additional support and stability to the injured joint during the healing process. This can help prevent further injury while allowing some movement.

Advanced Treatment Options
If conservative management does not yield satisfactory results, further interventions may be necessary:
1. Corticosteroid Injections: If inflammation persists, a corticosteroid injection into the joint may help reduce swelling and pain. This should be considered carefully, as repeated injections can have side effects.

2. Platelet-Rich Plasma (PRP) Therapy: This involves drawing your blood, processing it to concentrate the platelets, and injecting it into the injured area. PRP has shown promise in promoting healing in soft tissue injuries.

3. Surgical Consultation: If there is significant ligament damage or if conservative treatments fail, a consultation with an orthopedic surgeon may be warranted. They can assess whether surgical intervention is necessary to repair the ligaments or stabilize the joint.

Monitoring Progress
Keep a close eye on your symptoms. If you notice any worsening of pain, swelling, or changes in function, it’s crucial to follow up with your healthcare provider. Regular follow-ups can help adjust your treatment plan based on your recovery progress.

Conclusion
In summary, managing finger joint pain after an injury involves a combination of rest, rehabilitation, and possibly advanced treatments if conservative measures fail. It’s essential to work closely with healthcare professionals to develop a personalized treatment plan that addresses your specific needs and allows you to return to your daily activities, including your job at the beverage store and playing music. Remember, patience and consistency in your rehabilitation efforts are key to a successful recovery.

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