Thums - jewelers syndrome?

Many of you have been in the industry for several decades, just as I
have.

For the last six months I’ve experienced daily the “click/lock”
episodes in the first joint of my thumbs. This must be due to the
extreme overuse of the thumbs for pressure and torque in our
industry. Mornings are worst, and careful movements are needed to let
them get back to full range of motion. Has anyone found a foolproof
way to deal with the adhesions that develop after years of repetitive
usage? I’ve got to work at the bench for quite awhile longer before I
can even consider walking away. Any and all help is appreciated.
B.T.W. I have not had health insurance for five years, so a Dr.
consultation is out of the question.

Thanks!
Margie Mersky
mmwaxmodels.com

Margie - I have what is known as “trigger finger” in several fingers.
I wish I had something more positive to tell you but this is what I
have been told by my doctor about the condition: best thing at first
is rest it (ha ha - as if that is an option) - apply a splint if
necessary; there are also gloves sold that are fingerless allowing
you to use fingers but they help prevent the “lock” because they
just don’t let you flex that far. Immersion in the morning in warm
water often helps get started in the day. Massage and flex the
fingers - all of them - because when you have one finger affected, it
is likely more will develop the condition so keep up the circulation
and movement. If it gets painful, only you can judge if it painful
enough for surgery. And only a doctor can tell you if the thumb is a
good candidate for surgery. I would investigate the gloves if I were
you - I use them from time to time. I find them tight and not that
comfortable but I tell myself they are for my hand’s benefit and
talk myself into wearing them. My condition comes and goes.
(Thankfully) It’s the grasping motion that is the culprit apparently.

Good luck - I hope you can find some comfort.

Barbara

I am replying to the no health insurance. If one makes a choice not
to have health insurance they should have a plan for self insurance.
If one puts $50.00 a month away for 5 years you would have $3000.00
for medical expenses. Granted 3K would not cover a huge problem but
it would make a small problem, not a problem.

Bill Wismar

Has anyone found a foolproof way to deal with the adhesions that
develop after years of repetitive usage? 

The answer to maintaining dexterity, at least for me, has been
exercises with Baoding Balls. Youtube has many introductory videos on
the subject. The idea has been commercialized to a degree, so not
everything you hear about is true, but it is a worthwhile exercise.

Leonid Surpin

Hi Margie,

Well yes, it hit both of my thumbs and a cortisone shot took care of
the problem in one but not the other. I had to have surgery on my
right hand. My thumb locked out on the right hand and in on the left,
luckily they didn’t happen at the same time. I really worried about
the surgery, but it turned out to be nothing. I had it done 9 years
ago and I’ve had no problems since.

You could try acupuncture, it did help me for quite a while.

hope this helps,
Jennifer Friedman
Ventura, CA

Margie - sounds like what my doctor calls “trigger thumb”. Feel along
the base of the thumb and see if there is a noticeable bump. I’ve had
mine injected with steroids about 4 or 5 times now, and each time the
“fix” lasts a shorter time. My doctor says surgery is in my future,
but as I too have no health insurance I’m doing everything else I
can.

I find that wearing a brace at night helps significantly - it is
meant to be a carpal tunnel brace, with a metal insert, and I stick
my thumb inside the wrapping so it doesn’t move during the night. I
also find that wearing a good wrist/thumb brace during the day helps,
depending on what I’m doing. The next big thing for me is the
computer mouse - something about my mouse tends to aggravate the
trigger thumb if I’m on the computer a lot, so I try to pay attention
to that.

Good luck!

Beth Wicker
Three Cats and a Dog Design Studio

Hi Margie

For the last six months I've experienced daily the "click/lock"
episodes in the first joint of my thumbs 

I have the same problem with my index finger. Its often called
“Trigger Finger”. It can be caused by repetitive stress and my
doctor informed me that it is also a common problem for diabetics
(which I am). It is caused by tendons swelling and then sticking in
the tubes they travel through in your palm and finger. If you search
“trigger finger” on the internet, there are many references. The best
way to make it go away is to stop doing the repetitive thing that you
were doing that caused it. This is kind of hard to do if you make
your living with your hands. WebMD suggests Ibuprofen to bring down
the swelling and reduce pain I have had it before and it eventually
went away. This time, I have had it for 9 months and it does not seem
to be getting better. Doctor has suggested surgery… but I don’t
think I want surgery for a nuisance problem like this. For now I plan
to live with the mild pain and annoying clicking.

Regards
Milt
Calgary Alberta

This time, I have had it for 9 months and it does not seem to be
getting better. Doctor has suggested surgery... but I don't think I
want surgery for a nuisance problem like this. For now I plan to
live with the mild pain and annoying clicking. 

I’ve had a similar problem with the fourth finger on my left hand.
I’d close my fist, and then be unable to open up the bend in that
finger without pushing it open with the other hand or something.
(I’ve now been a type 1 diabetic for 43+ years, so this condition
wasn’t a great surprise). So I had that surgery. Office surgery,
local anaesthetic, took about an hour. Took a bit longer to heal than
I’d expected, but not by much. While I still can’t always totally
straighten the finger (or the adjacent little finger) without some
effort, the whole process basically worked well. Lost no strength or
important ability in the finger, so if you’re worried about the
surgery simply because it’s surgery, I can at least attest that for
me, I’ve had no regrets about doing it, and the discomfort and
annoyance totally went away.

Hope that helps
Peter

Margie,

Have you tried starting the morning with your hands in warm wax? The
unit used in Nail Salons? I bought one at WalMart some time ago.
Have not yet tried my home unit, but I love the feeling I get during
a manicure.

I do know what hand joint discomfort is, as I have Hebreden’s (SP)
Knots, in the first joints of several fingers. It is a form of
arthritis causes my upper finger to point off center. Frequently hit
the wrong key while typing.

Hope you find some relief.
Hugs,
Terrie

Teresa Masters
www.metalsmith.co

I don’t want to make a diagnosis—you need a doctor for that—but
it sounds like Trigger Finger, which does not involve an adhesion,
but rather a swelling in the tendon that flexes the finger, that
gets caught on one of the “pulleys” that helps guide that tendon. If
you google “trigger finger” you will find a lot of It is
definitely worse in the morning when hands are swollen from lack of
movement during the night. It’s important not to just pull the
finger open because that irritates the tendon even more, but rather
gently work it open with little movements in the joints that still
move freely.

I am a retired Occupational Therapist who has worked with trigger
finger, and in fact had it myself in my pinky finger. In my case.
with time (rest) and conservative treatment (gentle exercises called
tendon blocking exercise), the trigger finger resolved itself. Some
info says surgery is the best treatment, but my experience (with
clients I’ve worked with) has been an injection of a cortisone in the
area works great. Try conservative treatment first…then consider
seeing a doctor who specializes in hands and/or an occupational
therapist who specializes in hands (a Certified Hand Therapist).

Good luck.
Lorraine

What you are experiencing is most likely “trigger finger”. It was
described to me as the effect of trying to push your hand through a
buttoned cuff, eventually you can shove it on through but you can’t
pull it back out very easily. When you have “trigger fingers” the
tendons are sticking as they slide through the sheaths - they stick
when trying to get them back through. When they do surgery, what
happens (over simplified) is they “snip” the “sheath” so the tendon
can slip through and return with no problem (and no pain).

It takes several months after the surgery before the fingers are as
limber as they were to start with, but it does eventually settle in
and is wonderful. There is really only minimal discomfort after
surgery - primarily an inconvenience to keep the incisions dry for a
week afterwards.

I lived with trigger fingers and rigger thumbs on both hands and
trigger thumbs for several years. When it got so blasted
inconvenient that I could hardly hold my torch (couldn’t let it go
easily) was when I said enough and had the surgery on both hands at
once. Annoying for several weeks, but then it settles down. The
middle fingers were rather stiff for a month or so, but there was no
more pain. After about 4 months, there was no indication I had ever
had a problem and I’m sorry I didn’t go have the surgery sooner. The
results were fantastic and it was such a delight to be pain free
after all those years of worrying with it.

Actually you can use your hands right from the beginning (well after
about a week) and you will wonder why you waited so long to get it
taken care of.

Once it is present, it rarely goes away. I’ve had carpal tunnel and
worn braces 24/7 and it helped, if somewhat inconvenient. but
trigger fingers never went away - only surgery finally resolved the
issue.

What I have found helps a lot, is the use of paraffin baths for my
hands (I also suffer with osteoarthritis and have really knobby
finger joints.) So now I keep a paraffin bath set on a timer switch
and just soak my hands in the paraffin every night. Annoying to do,
but very helpful. So there is help out there. If your trigger fingers
(thumbs also) are really aggravating, then go have the surgery. Just
find a good orthopedic surgeon, preferably one who has done this
surgery a lot (mine had done an enormous number of cases). You will
be happy you did.

Kay

Pain Management Dr. can give you steroid injections that will make
the swelling go down.

For the last six months I've experienced daily the
"click/lock"episodesin the first joint of my thumbs. 

Sounds like Margie might have trigger finger, as some have said. I’ve
never heard the term, but as usual Mayo Clinic is pretty thorough for
a small article:

Of course, getting a medical diagnosis on a computer forum is
unwise, IMO and many others, too. Just for another perspective,
though, I am moderately double-jointed (I’ve known people who were
much more). I can bend the first knuckle of my fingers in that
typical way of double joints. I can bend my left thumb up on to the
backside of my palm at 90 degrees, and worst of all my middle toes
will pop out of joint spontaneously at times, which hurts like a MF.
Almost drowned once because of that. All of which means that I
periodically have joint problems and locking knuckles and muscles
pulling my fingers into strange ways over the years. My case doesn’t
really seem to be, actually. trigger finger from the descriptions I
read just now. Just strange joints which I’ve always had. I just
rest, maybe pull the muscle backwards to stretch it. Sometimes I
truly change my behavior - use different pliers, take a different
posture, use my left hand, what have you. It might not work for any
or all of those who have posted, but my case isn’t what you’d call
severe.

Henny Youngman: Doc it hurts when I do this.
Doc: So stop doing it…

Margie,

It’s really a shame that you can’t see a doctor and a physical
therapist, especially since your livlihood depends on the use of your
hands. Sounds like repetative motion injury that has resulted in
tendonitis. I’ve delt with the same problem for over 6 years in my
forearms due to typing at the computer all day at my job. I’ve seen
doctors, a neurologist and physical therapists. The only thing they
tell me to do that will completely heal the arms is to quit my job
and change my career. Since I can’t do that right now, I’ve learned a
few tricks -

  1. Every day I apply Traumeel (an anti-inflammatory cream that you
    can get at Whole Foods or Sunflower Market or maybe Vitamin Shop).

  2. I massage my arms out including all of the muscles surrounding the
    elbows and tendons (try to massage as deeply as possible to loosen
    up the muscles and tendons, I use a plastic thing that I bought at a
    phys therapist’s office).

  3. I take small block of ice - I fill baby-size bathroom cups with
    water and freeze them, then peel back the paper and apply the ice
    directly to the skin and rub it around for at least 5 minutes or
    until the skin is numb to the touch.

This strategy is the only thing I have known to keep this tendonitis
in check. I have to do it every day before bed, if I skip a day I
will notice and the tendonitis will get a lot worse. The only other
thing I can tell you is to NOT ignore it because if you do it will
only get worse and you will eventually lose the use of your thumb
and/or have to have surgery.

You might also check the ergonomics of your bench and change the way
you are doing some things that requires the use of that thumb…

Good luck,
Jennifer

Beth

Perhaps a ball instead of a mouse would help your hand. It twirls
with the slightest movement of any finger. I found holding the
regular mouse also strained my wrist and the ball gives me no
problems at all. Just an idea.

Ruth Mary

If one makes a choice not to have health insurance 

Dear Bill - “one” does not “make a choice” not to have health
insurance. “One” (being myself and those I know personally without
health insurance) is refused coverage due to pre-existing conditions,
and/or due to being self-employed and not qualifying for group
coverage, and “one” can’t afford the $1,500/month government policy.
This is not, in any way, a “choice” that “one” has made, but rather
the result of choices our society has made as to where we will spend
money, and what our priorities as a society are. Self-insuring is
viable only IF “one” has no major health issues AND “one” has the
financial ability to fund a self-insurance account. Again, “one”
doesn’t choose “one’s” health issues nor to a large extent “one’s”
financial status (this last one we as individuals do have more
control over, but in this economy, that is much more limited than
when the economy was booming).

I would respectfully suggest you walk a year in “one’s” shoes before
becoming condescending about an issue you are woefully misinformed
on.

Beth Wicker

Sounds like “trigger thumb.” Try using a brace made for just that
during the night. I was given a cortisone injection when I had it in
my left hand two years ago. It hasn’t come back. I now have it in my
right hand, but not painful or disabling enough (yet?) to warrant an
injection.

Jette Sorensen

Warm wax helped me a great deal. Plug it in, heat the wax, dip your
hands in, encase them in a plastic bag, daydream a bit, wax then
pulls off and is returned to the melted bin. Change the wax once in a
while. Something about deep heat helps. It’s in Wal-Mart type places
in cosmetic section.

I had it in my left middle finger - I took the cortisone
injections - it helped for a while and all came back.... 

i had a segury few month ago - and I am so happy I did it. Now I have
it on my right hand and I am going to take care of it as well.

Beth is right. I’m a Canadian and couldn’t retire full time to a warm
climate if I wanted to – here, I have government coverage, not
perfect of course, we have trouble getting and keeping gp’s and
certain specialists, the wait lines can be long for certain
surgeries etc, but I would likely be denied private coverage in the
US, Mexico or other warm place. It is only when you lose your health
that you find out how many options you have lost along with it. But I
do find that physio theraapists and occupational therapists re very
accommodating, Beth, and can give you some advice in one
appointment. It gets to be a circle - making the money with your
hands to pay for the bills to keep the hands working to make the
money for your hands… I empathize.

Big hug from a person on a little island on a ruddy cold night!

Barbara