Trigger finger surgery anyone?

Slash'N'burn · January 2022

Has anybody had this done (or similar) privately in the UK, and can recommend a hand surgeon?

My fretting hand index finger has swollen up again is and is completely useless. I started having issues 2 years ago, was given a steroid injection on the NHS about a year ago, which never really fixed it properly (still had some pain and restriction)

if I stick with the NHS I could wait months to be seen again then six months wait for another steroid injection, struggle for another year etc, then a long long wait for the eventual surgery.

Thinking about seeing if I can get the trigger finger surgery done privately, the problem is just getting in the way of life/work/sport and guitar.

If anyone has any recommendations for surgeons/hospitals they will be really appreciated.

stufisher · July 2022

I'm also interested in such ... I've been struggling on with similar symptoms for the whole of 2022.

I've read through all of the previous threads on this and researched heavily the available intel on DuPuytrens, CTS, arthritis.

I haven't been to my GP recently but I had trigger finger in my strumming had about four years ago and had the same symptoms. I hadn't started to re-learn guitar at that point and it took about 6 months for the symptoms to subside.

Based on my own experience I decided to endure the current bout of symptoms but clearly it is taking a lot longer because I'm now playing guitar (painful though it is).

I've been thinking about percutaneous surgery because it's a keyhole procedure under local and the recovery time is about two weeks apparently (ref NHS website).

The underlying issue for me is that I have type 1 diabetes and they're always reluctant to do any procedure because of added complications. It might take me ages to get this sorted via NHS so I'd deffo consider private surgery.

Any reccos would be very welcome.

Stu

TheMadMick · July 2022

Am I completely out of date? Don't you need to get a referral from your GP?

Slash'N'burn · July 2022

stufisher said:

I'm also interested in such ... I've been struggling on with similar symptoms for the whole of 2022.

I've read through all of the previous threads on this and researched heavily the available intel on DuPuytrens, CTS, arthritis.

I haven't been to my GP recently but I had trigger finger in my strumming had about four years ago and had the same symptoms. I hadn't started to re-learn guitar at that point and it took about 6 months for the symptoms to subside.

Based on my own experience I decided to endure the current bout of symptoms but clearly it is taking a lot longer because I'm now playing guitar (painful though it is).

I've been thinking about percutaneous surgery because it's a keyhole procedure under local and the recovery time is about two weeks apparently (ref NHS website).

The underlying issue for me is that I have type 1 diabetes and they're always reluctant to do any procedure because of added complications. It might take me ages to get this sorted via NHS so I'd deffo consider private surgery.

Any reccos would be very welcome.

Stu

Stu,

I'd almost forgot about this thread, and the other much longer one I wrote about 2 years ago.

For me , it turned out not to be trigger finger - I'm under care of rheumatology now and recently they think I may have early systemic sclerosis or connective tissue disease - I have some kind of blood vessel damage, which may be causing my fingers to swell, which irritates the tendons/pulleys which gives me trigger finger like pain amongst other issues.
Although I must stress what I have is pretty rare.
I could barely play guitar for the first six months of the year, but it's eased off at the moment and I'm playing again, in a band and making the most of it while it lasts. Heavy lifting or gripping is a complete no no though.

What issues do you have? Do your fingers lock? Or get painful at the base? I would go to your GP about it, as well as considering private - you would probably need a US scan which should highlight trigger finger, possibly blood tests.
I've seen the ads for cheap/quick percutaneous release surgery, I'd be wary as you need investigations first.

Andy

octatonic · July 2022

Slash'N'burn said:

Has anybody had this done (or similar) privately in the UK, and can recommend a hand surgeon?

My fretting hand index finger has swollen up again is and is completely useless. I started having issues 2 years ago, was given a steroid injection on the NHS about a year ago, which never really fixed it properly (still had some pain and restriction)

if I stick with the NHS I could wait months to be seen again then six months wait for another steroid injection, struggle for another year etc, then a long long wait for the eventual surgery.

Thinking about seeing if I can get the trigger finger surgery done privately, the problem is just getting in the way of life/work/sport and guitar.

If anyone has any recommendations for surgeons/hospitals they will be really appreciated.

Had hand surgery in 2009 for this precise issue.
My fretting hand, index finger, so critical to get right.
My surgeon was Ian Winspur, he wrote a book called 'Musician's Hands'.
He is in Harley Street.
As you might expect, he was quite good, but it will be expensive if self funding (ie you don't have private health insurance.
I think Bupa paid about £6k, but I am working from memory so might be wrong.

I made a full recovery but it took 2 years, I was playing and gigging within 3 months.
I have a small scar.

merlin · July 2022

Pretty much every surgeon in the UK who works for the NHS also does private surgery. I had trigger finger on the middle three of my right hand (at the same time) and then a few years later my left index finger.

My surgeon did an excellent job. She was Lisa Leonard and although the surgery was done under NHS, I have the procedure at a private hospital in Brighton, for reasons I don't know.

Although I suspect that the surgeon @octatonic had was probably a better fit for the attention to musicians details.

prowla · July 2022

Coincidentally, I bashed my finger last week and it didn't seem to be getting better, so I went to a minor injuries unit; it turns out it was broken and the end joint is what's called "mallet".

I've now got to wear a finger splint for 8 weeks!

stufisher · July 2022

Thanks for the update @Slash'N'burn and thanks all for other insights and recommendations.

Really pleased to learn that you got accurate diagnosis and remediation Andy ... I wish you well with continued enjoyment of playing ... long may it continue.

To answer your questions ...

Yes, my left index finger locks intermittently but the whole area from the base of my left thumb across to the base of my middle finger is constantly inflamed, swollen and resistant to movement. First thing every morning I need to manipulate/force-flex the area using my right hand. The thing that gives greatest pain relief and most flexibility is strong pinching of the median nerve centre.

I can't play guitar at all some days but generally I can endure about an hour. I have to play with a much lighter touch though and 10 mins of acoustic can be agony

Open C, F and Dm7 are very tough ... and lazy A with index finger only isn't much better.

I take your counsel and will see GP first. I had to get US scans for a torn shoulder about 5 years ago and that identified soft tissue damage and informed remediation plan ... it may also offer up a similar resolution with my new challenge. I know they'll not wanna slice'n dice a 60 yo diabetic without good cause ... I don't think guitar-playing will count as a valid reason.

On a more positive front, I have started to play chords differently to avoid the intense pain ... so rearranging fingers/ finger positions for C and F and learning new shapes, inversions etc. which is never a bad thing.

Anyway, in due course I'll update the thread but for now, thanks again to you all.

Stu

Jalapeno · July 2022

Update on my Thumb problem - met with Consultant Surggeon, approved for a Trapezium joint replacement - like a knee replacement in miniature. 6 month-ish waiting list, but at least I'm now on it. Recovery time is a only few weeks apparently.

stufisher · September 2022

Update on my hand pain/probs ...
Haven't seen a doc and been away for a large chunk of August, so been laying guitar a lot less.
Continued with daily, multiple, median nerve-pinch self-treatment to alleviate acute pain and it appears to be working.

In the last week a lot of pain-free mobility has returned to my hand and index finger in particular, so I've been able to play for about two hours without agony the next day

I intend to persevere with current regime as it's the best I've felt since Easter this year

Hope this info might help someone else too.

Stu

luke_87 · April 2023

@stufisher I'm currently experiencing pains in the middle knuckle of my index finger on my fretting hand (left) and was wondering what kind of daily exercises you've been doing and did they work in the long run? I'm at a point where I'm not sure if full rest is better, or whether joints can seize up and would prefer movement/light massage?

To explain my issue specifically, the middle knuckle of my index finger on my left hand feels bruised to touch (specifically along the thumb size) and is also painful when crunched into a fist. Similarly when keeping all other fingers straight and crunchy just that index finger - that also causes a bruised-like pain. As you mentioned, this is making Open C, Dm and Dm7 etc very tough which is why I've decided to rest altogether.

bertie · April 2023

stufisher said:

intel on DuPuytrens,

this is what I have, currently just lumps along the ring finger tendon/palm - no "constant" pain and no real tightening, but it is very uncomfortable and sore/pain if used for things like opening jars, and the soft V neck on my Furch is uncomfortable now (but not the others )

It will, apparently lead to trigger finger, and was advised by my local health centre (we dont have assigned GPs) that NHS wont touch it before its stuck at 30 degs - tho the private consultant that did my elbows ( insurance I had while working) would've have done something

Im just monitoring the situation at present

TheOtherDennis · April 2023

I had trigger finger surgery last year on my left index finger, and it's completely cured the problem. A small, barely noticeable scar on my left palm is the only sign.

musteatbrain · April 2023

It’s quite a slow progressing disease usually. Mine seems fairly static over the last 3 years.

I have a look through the current research papers on how this is treated and things are starting to look up:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9996772/

There’s some promising treatment options on the way in the next few years.

nero1701 · April 2023

I have Dupuytrens contracture on my pinkie, ring and index finger on my right hand. I'm waiting on a period of 2 years of no discussion of it with my doctor as my private medical does not cover pre existing...but will treat with 2 years no doctors.

I did injure my ring finger playing guitar november/december last year and had to splint it for a spell..but seems to be okish for now.

Slash'N'burn · May 2023

nero1701 said:

I have Dupuytrens contracture on my pinkie, ring and index finger on my right hand. I'm waiting on a period of 2 years of no discussion of it with my doctor as my private medical does not cover pre existing...but will treat with 2 years no doctors.

I did injure my ring finger playing guitar november/december last year and had to splint it for a spell..but seems to be okish for now.

Is DuPuytrens classed as autoimmune disease? Did you get referrered to Rheumatology?

Slash'N'burn · May 2023

My trigger finger type issues, as part of my systemic sclerosis condition, seemed to be slowly improving in my index finger, I had no pain for a few weeks and it seemed to be stronger.. but then i started playing a little more physically and bang it was back again(soreness at the base of the finger..still playing but more carefully now, it's sore on and off. Back to using ibuprofen gel on the palm.
I've seen a few trigger finger exercises on YouTube etc. by physiotherapists, seem to get good comments /results, might be worth trying.

My worst issue now for guitar playing is secondary Raynauds, which is damaged Capillaries/circulation in the fingers, when I get warm my fingers swell up and stiffen, which makes playing lead very clumsy and difficult. As the weather is warming up I've had to tell my bandmates that I can't play lead anymore.

It's shit what life throws at us isn't it?

bertie · May 2023

Slash'N'burn said:

Is DuPuytrens classed as autoimmune disease? Did you get referrered to Rheumatology?

not that Im aware of, Ive certainly never had that mentioned to me. Its just an abnormal thickening of the fascia layer under the skin

nero1701 · May 2023

Slash'N'burn said:

nero1701 said:

I have Dupuytrens contracture on my pinkie, ring and index finger on my right hand. I'm waiting on a period of 2 years of no discussion of it with my doctor as my private medical does not cover pre existing...but will treat with 2 years no doctors.

I did injure my ring finger playing guitar november/december last year and had to splint it for a spell..but seems to be okish for now.

Is DuPuytrens classed as autoimmune disease? Did you get referrered to Rheumatology?

Not that I know of, I do have an autoimmune condition, but do not think they are related

Slash'N'burn · July 2023

A new development in my condition, problems with my right thumb - swelling and stiffness between the end of the thumb and the end joint, pain at the end joint, then later clicking at that joint. Swelling started to go down after about 3 weeks, couldn't even hold a pick at one point or do a thumbs up, it improved for a few weeks then the soreness started creeping in again, then swelling came back.
I've not had finger/thumb joint problems before, does this sound familiar to anyone?
Reported to my Rheumatology helpline, they're referring me to occupational therapy (?) doesn't sound like they'll be any investigation/scan.

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Trigger finger surgery anyone?

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