Trigger finger and the cortisone quandary

Had a mild bit of this for a while, left ring finger, but in the last week it has flared up to a constant pain. Not terribly intense by normal standards, but…

I can’t play guitar!!!

At all. Might be what flared it up to begin with: a new Lowden F32C acoustic that sounds so glorious I can’t stop playing it–or rather, couldn’t, until this cropped up. And I’ve got a fairly major gig coming up in late August. And an appointment to a hand orthopedist in a week or so. Who, my PCP assured me, will almost certainly be able to take care of it with… da da da DAH! that greatest of all BG evils…

a cortisone shot.

Yeah. I’ve been avoiding those for over a decade, ever since I had one for shoulder pain back when I was still on R/N, and my BG’s were uncontrollable for a couple of weeks. Posted on it many times here, because a lot of us, as well as our orthopedists and GPs, still aren’t necessarily aware of what that stuff does to T1s. On top of which I’ve been desperately trying to cut down my TDDs in order to (try!!!) to lose some very stubborn poundage, and the prospect of jacking up my basal by 70% or godknowswhat really doesn’t appeal. But with that gig coming up, I may just have to bite the proverbial bullet.

I’ve tried icing it, taking ibuprofen to knock down the inflammation, declared a guitar moratorium, so far no joy. Of course ultimately there’s a minor surgical procedure, but given the time frame there’s no way that’s going to have healed up in time. Any others with trigger-finger experience who have found a better answer? Ugh.

I did not have any issue with the 3 cortisone shots i have had in my life. I would do it again if i had another trigger finger.

Well with the current time frame, I don’t know if there is much you can do other than knocking it down with conventional medications as much as you can. However, allow me to suggest some unconventional methods to help with your situation.

For knocking down inflammation and dealing with pain (and many other reasons I won’t go into), I would highly suggest trying and practicing meditation. I’ve gone on a 10 day Vipassana retreat (twice, and will again) and have never looked back on it. Some science on the topic -->

I haven’t had trigger finger, but can attest to the effects it has had on my pain, anxiety, and functional scoliosis. Also reduced my TDD because of it. Perhaps it may help in a way?

Best of luck and wishing you well with your gig. (very nice guitar btw).

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I’ve had 4 trigger fingers, and a de Quervain’s, and an extensor carpi ulnaris stenosis too. It’s not my T1D, it’s my delightful psoriatic arthritis, now held at bay by oral biological agents :blush:.

The steroid shots suck for BSLs (I need 150-170% of my basal), and for me, they mostly don’t work, so surgery is the go.

I played with my pipe band in our longest street parade 48 hours after surgery, and another shorter parade 72 hours after surgery (4 weeks later, other hand). Stitches still in, a bit sore, but my fingers were free! And mobile, and moving much faster than 2 days before. It’s a really quick recovery time, and for me, totally worth it, even with gigs coming up. My surgeon told me to “take it easy” for 48 hours, so I did. Sort of.

I’m a bagpiper, and my most recent trigger fingers were left index (very active piping finger on the top hand), and right middle (slightly less active but still quite important for Bs and Cs).

I’m an avid embroiderer. Had trigger finger first in my left middle finger, then my right. Went straight to surgery both times because the surgeon felt cortisone shots would be useless. He encouraged me to use my hands as soon as the block wore off, massage the incision site as tolerated and stretch as tolerated. No need for physical therapy, healed and flexible in a few weeks.
Recently my left index finger started locking. This time I used ice, stretching, massage of the ‘nodule’ thingie in the palm, ibuprofen and warm water baths to reduce swelling and restore flexibility. I also used a splint at night to hold my fingers straight. No more locking or pain after a couple months of home therapy. YMMV.

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I’ve had 2 trigger finger releases and both fixed my fingers 100%, after intense pain. Forget injections; have surgery. My ortho guy (awesome doctor–known him for years) says it’s a waste of time to do injections for trigger finger on diabetics. they ultimately need surgery to correct the problem.

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Thanks to all for the very helpful feedback! I’m probably going to have to have the shot in order to do the gig, since the earliest appt. I could get is only 2 days ahead of time. Guess I’ll just have to deal with the BG issue (if it’s just a teeny little shot, maybe it won’t be so bad, I keep telling myself).

But @Dave44, yeah, I’ve been thinking along those lines. I’m going to address that with the specialist–ultimately I need the thing to be fixed, not just temporarily ameliorated.

It has been particularly painful overnight–splint sounds worth a try.

Good to hear. I’ve been thinking it might not be as bad as the one I got for a shoulder problem years ago that took weeks to wear off. That was a big joint and presumably required a larger amount, vs this teensy little finger bone.

Not all steroids are the same - ask your doc to try another. I did and the increase went away - have had multiple injections - only the first did the rise.

Thanks Mike! My regular Dr said something to that effect too. I was going to check with my endo and hopefully communicate it to the orthopedist before the appointment.

I have also made many, many tigger releases done on multiple fingers and two have been done twice. Early on, we would try injections with the understanding that basal rates would go up and I would be testing/correcting more often. After all these fingers being done, now we just schedule surgery. Injections just don’t seem to work for me any longer. Recovery is pretty quick. Some i’ve had physical therapy and some I haven’t. Can’t give you any advice because what works for me might not work for you. But I do think trying an injection might help you completely. And no one wants surgery if they can avoid it.

I’ve had trigger finger twice now. The first time I had my acupuncturist work on it when I was already going for my back. It took about 4-6 visits, (4-6 weeks). The second time I had only a couple of treatments and I already knew the massage points, but it did take longer to go away and was more painful with less treatments. I had seen the ortho who wanted to give me a shot, but my BG levels shoot up with a shot, so I didn’t want to go that route.

Surgery here. Dr didn’t want to affect Blood sugars. The surgery is pretty easy and I have had it twice so far. Just go ahead and get it done when you have the time.

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What AD1 said! Verbatim, actually. lol.

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Yeah, I’m going to go ahead and ask to have that scheduled, but alas my deadline for being able to play my upcoming gig is only a week from now, so I’m stuck with the shot in the near term.

I’ll keep good thoughts and prayers going your way! I had the shot in my thumb a few years ago. It helped a lot.