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- Sun Nov 01, 2009 4:30 pm
The middle finger on my right hand has been swollen/inflamed nearly constantly since the end of August. The swelling is greatest around the minor knuckle, but the area in between the major knuckle and minor knuckle is also quite inflamed. The area distal from my minor knuckle apparently has no swelling.
My entire middle finger is quite stiff. I am able to move it, but sometimes it is moderately painful (about a 5 or 6, if 10 is the greatest pain I've ever felt). It is usually very stiff overnight and when I first wake up. It will usually wake me up overnight though, and it’s very hard to find a position to sleep in which it does not bother me. The pain can sometimes be sharp, but it is usually a very dull and aching pain (this is when nothing is touching it). If I push on the inflamed part I feel slightly more pain, but not that much as the skin there (i.e. epidermis/dermis) feels numb. I have good sensation distal from the minor knuckle, but very poor sensation between the minor and major knuckle.
Initially I thought this problem was due to repeated stress to the finger. I would estimate that over the summer (May-August) I used a computer on average 40hrs per week. My hand was nearly always on a mouse, and with the way my middle finger is positioned on the mouse when I use it, it seemed to me that I had strained it from overuse. As best I can remember, I did not do anything else consciously that could have injured it.
The inflammation has increased over time. It seems greatest when the weather is warm. When the weather got very cool a few weeks ago my finger seemed to go back to near normal size and hurt me very little. But now the weather has gotten warmer again, it is bothering me more than ever. I'm not saying that it is definitely related to the weather, but I have noticed these changes in it with the weather.
Therefore, I have begun to think that I could have some type of arthritis or autoimmune disease, or that something is seriously wrong. I have had two med student friends examine my finger. One said it may be a dislocation. The other said it was likely not arthritis, but it could be broken. Both recommended an x ray.
I tried taking Ibuprofen for a week. I took Ibuprofen 200mg, 3 times per day (200 mg in morning, 400 mg at night with dinner), for this past week. I seemed to find some minor alleviation of the problem with this (minor decrease in pain and minor decrease in inflammation), but overall the problem has not been solved. Now that I have gone 2 days without the anti-inflammatory, the condition seems to be as bad as it has ever been.
I don't have health insurance, so I'd like to narrow down this problem as far as possible before going to the doctor. I would prefer not to have to go the doctor or get an x-ray unless it is absolutely necessary.
Thanks for any help
| Tom Plamondon PA-C
- Fri Nov 20, 2009 1:18 pm
I doubt that the finger is fractured considering there has been no trauma.
It sounds like repetitive stress has caused an acute arthritis in the digit.
Ibuprofen could be increased to 800mg 3x a day with food for a couple weeks.
Apply ice and / or hot packs.
Gentle range of motion after the hot pack.
If no improvement in 2 weeks, x-ray it.