Trigger Finger: Post-Surgery Pain and Recovery Insights

Q: Trigger Finger: Post-Surgery Pain and Recovery Insights

Hello： Your issue is likely not related to trigger finger (as that should have been resolved after surgery). <br>The persistent soreness and weakness in your right hand, along with the inability to fully bend your fingers and the stiffness and swelling of the joints, may indicate

Trigger finger

I have been suffering from trigger finger in my right middle finger for many years.
After multiple courses of anti-inflammatory medication and two local steroid injections that were ineffective, I finally underwent surgery in early July 2008 to release or excise the adhesions in the tendon sheath.
I hoped this would resolve the issue completely, but it has been almost four months since the surgery, and I still feel pain.
My entire right hand often feels sore and weak.
Although I can extend my fingers, I am unable to bend them completely, especially when making a fist or holding a pen.
My fingers feel stiff, and the joints are swollen and deformed due to inflammation.
During my follow-up appointment, the surgeon simply advised me to continue with heat therapy and prescribed anti-inflammatory medication.
Is this situation normal? Could it be a postoperative complication? What should I do now?

linenru, 40~49 year old female. Ask Date: 2008/10/06

Dr. Li Wenlin reply Orthopedics

Hello: Your issue is likely not related to trigger finger (as that should have been resolved after surgery).
The persistent soreness and weakness in your right hand, along with the inability to fully bend your fingers and the stiffness and swelling of the joints, may indicate tenosynovitis or arthritis (osteoarthritis or rheumatoid arthritis).
I recommend consulting an orthopedic surgeon or a rehabilitation physician to determine if additional rehabilitation therapy is necessary.
Wishing you all the best.
Director of Orthopedics, Keelung Hospital, Li Wen-Lin.

Reply Date: 2008/10/06

More Info

Understanding Trigger Finger: Post-Surgery Pain and Recovery Insights
Trigger finger, or stenosing tenosynovitis, is a condition characterized by the catching or locking of a finger in a bent position due to inflammation of the tendon sheath. Surgical intervention, typically involving the release of the constricted tendon sheath, is often pursued when conservative treatments such as anti-inflammatory medications and corticosteroid injections fail to provide relief. However, as you have experienced, post-surgical pain and limited mobility can be concerning and frustrating.

It is not uncommon for patients to experience ongoing discomfort and stiffness in the affected finger after surgery. The healing process can vary significantly from person to person, and several factors can influence recovery time and outcomes. Here are some insights into your situation:
1. Post-Surgical Pain: After surgery for trigger finger, it is expected that some pain and discomfort may persist as the body heals. This can be due to inflammation, scar tissue formation, or even nerve irritation. The pain you are experiencing, particularly if it feels like a deep ache or soreness, can be a normal part of the recovery process. However, if the pain is severe or worsening, it may warrant further evaluation.

2. Stiffness and Limited Motion: Stiffness in the fingers post-surgery is a common complaint. This can be attributed to several factors, including swelling, scar tissue formation, and disuse of the finger during the healing process. It is crucial to engage in gentle range-of-motion exercises as recommended by your healthcare provider to help restore flexibility and strength. If you haven't been doing so, consider discussing a structured rehabilitation program with a physical or occupational therapist.

3. Swelling and Inflammation: The swelling and inflammation you describe, particularly around the joints, can be indicative of ongoing irritation or inflammation in the tendon sheath or surrounding tissues. Continuing to apply heat, as advised by your surgeon, can help improve blood flow and reduce stiffness. However, if swelling persists or worsens, it may be beneficial to consult with your surgeon or a specialist to rule out complications such as infection or excessive scar tissue.

4. Follow-Up Care: Regular follow-up appointments with your surgeon are essential for monitoring your recovery. If you feel that your concerns are not being adequately addressed, do not hesitate to seek a second opinion or consult with a hand specialist. They may provide additional insights into your condition and suggest alternative treatments or therapies.

5. Potential Complications: While most patients experience improvement after trigger finger surgery, some may develop complications such as persistent pain, stiffness, or even recurrence of symptoms. These issues can sometimes be addressed through additional therapies, including corticosteroid injections, physical therapy, or, in rare cases, further surgical intervention.

6. Psychological Impact: Chronic pain and functional limitations can take a toll on mental health. It is essential to address any feelings of frustration or anxiety related to your recovery. Support groups or counseling may be beneficial in coping with the emotional aspects of your condition.

In conclusion, while some degree of pain and stiffness after trigger finger surgery can be normal, ongoing or worsening symptoms should not be ignored. It is crucial to maintain open communication with your healthcare providers and advocate for your recovery. Engaging in rehabilitation exercises, managing inflammation, and seeking further evaluation if necessary can help you achieve a better outcome. Remember, recovery can take time, and patience is key as you work towards regaining full function of your hand.

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