Stretch inhibition of the fingers is when the fingers can no longer be stretched properly. In addition, affected individuals often experience pain.
What is extensor inhibition of the fingers?
Medical professionals also refer to extension inhibition. What is meant by this is a restriction of movement. Physicians also refer to an extension inhibition as an extension inhibition. This refers to a restriction of movement. It occurs when a joint can no longer be extended correctly and without pain – in this case, it is the fingers that can no longer be extended. A distinction is made between active and passive extension inhibition. Active stretch inhibition is when the affected person can no longer stretch the joint with the help of his muscles, but passive stretching is possible. If it is a passive extension inhibition, even the examining physician can no longer stretch the finger joint completely. The degree of extension inhibition is felt differently from person to person. In most cases, extension inhibition is associated with pain. However, it can also proceed without pain. The patient is unable to bring the affected finger out of a flexed position. Only by external postponing can a change in position be achieved.
Causes
In most patients, two causes are responsible for inhibition of finger extension. The first cause is considered to be the so-called snap finger, which is also known as flexor tendonitis or trigger finger. An inflammation in the tendon sheath is responsible for the extension inhibition of the affected fingers. The inflammation occurs in the thumb or in the hollow hand. It becomes noticeable through pain when the affected person wants to extend the finger. The cause of the stretch inhibition is a thickening of the tendon sheath and flexor sheath. Under the fingers, the flexor tendon passes into the tendon sheath within the palm. If inflammation occurs at the transition point between the tendon sheath and flexor tendons, this results in a narrowing of the entry point. If the flexor tendon thickens, there is no longer sufficient space for the tendon sheath, causing it to become trapped. This in turn leads to a blockage of the stretching process. The second cause of stretch inhibition is Dupuytren’s disease. This is a benign disease of the connective tissue on the inner surface of the hand. It is also known as Dupuytren’s contracture and belongs to the group of fibromatoses. Dupuytren’s disease particularly affects the little finger and the ring finger. In principle, however, the disease can manifest itself on any finger. Knot-like hardenings occur in the connective tissue. These are responsible for the inhibition of extension of the affected fingers. This results in an unnatural flexed position of the finger, in which an approach to the inner surface of the hand occurs. The affected finger cannot be extended, nor does it have sufficient strength.
Diseases with this symptom
- Snapping finger
- Gout
- Dupuytren’s disease
- Osteoarthritis
- Tendonitis
- Rheumatism
Diagnosis and course
Diagnosis can be stretch inhibition usually already by a physical examination of the attending physician. Thus, the typical symptoms are considered clearly recognizable. However, magnetic resonance imaging (MRI) may sometimes be required to obtain a clearer picture of the tendon and flexor sheaths. Dupuytren’s disease is most often recognized by a sudden snap of the affected finger. However, this requires a certain degree of stretching or bending. During a palpation examination, the physician detects nodular changes associated with Dupuytren’s disease. The different stages of the disease also play an important role in the examination. Thus, there are a total of five stages. In stage 1, Dupuytren’s disease is hardly recognizable, since the patient still has complete freedom of movement. However, lumps can already be palpated at this stage. In the further stages, the stretch inhibition is subdivided into degrees of severity. Thus, there is a classification from 1 to 5 degrees in stage 1 to 135 degrees in the last stage of the disease. This is the degree of stretch deviation from normal.Furthermore, in the further course of Dupuytren’s disease, skin folds are formed due to finger flexion. If the stretch inhibition on the fingers is diagnosed in time and appropriate therapy takes place, the pain can be effectively alleviated. In addition, the patient can move his fingers better again.
Complications
Complications of extensor inhibition of the fingers with and even without treatment are not uncommon. A physical examination by a primary care physician is sufficient to select the proper treatment, as the symptoms of finger extension inhibition are clear. Affected patients very often experience this inhibition as a great shock, as they can no longer move their fingers as they are used to. Further complications are not to be expected with an extension inhibition of the fingers. In rare cases, it happens that the inhibition is mild at the beginning and then worsens. This is an exceptional case. In the case of a snapping finger, it is necessary to choose between a surgical and non-surgical method. In case of surgery, the doctor must inform the patient about possible complications that could occur during the operations. If the patient’s inhibition is not so strong, the doctor will refrain from surgery, as this also reduces the chances of many complications. Daily massages and certain preparations containing cortisone are used. In this case, only experts should perform the massages. The chance of dislocating something during stretching is still too high. Nowadays, not many complications about these treatment methods are known in practice, although they exist in theory.
When should you go to the doctor?
As a rule, if the fingers are inhibited to stretch, a doctor should be consulted in any case. This symptom may be a serious illness or injury that definitely requires medical attention and, in most cases, will not go away on its own. An emergency physician should be called if the stretching inhibition of the fingers has occurred directly after an accident or if the symptom is associated with severe pain. In addition, the patient should not take painkillers for a prolonged period of time. If the affected person is not sure about the causes of the extensor inhibition of the fingers, the hospital or a general practitioner can also be consulted in the first place. In case of exact knowledge, the specialist can also be directly consulted for treatment. A treatment exclusively with means of self-help is not recommended in the case of stretch inhibition of the fingers. In most cases, good treatment of the symptom is possible.
Treatment and therapy
Treatment of extensor inhibition of the fingers can be conservative or surgical. If surgery is not necessary, consistent relief of the affected fingers is performed. Thus, the patient must not perform any manual activities or work with shovels. Since extension inhibition causes water retention within the flexor tendon sheaths, massages are performed every day, starting at the fingertips and extending to the palm of the hand. It is also useful to overstretch the affected finger with another finger. To combat the inflammation, the patient is given preparations that have an anti-inflammatory effect. If these do not have sufficient effect, there is the option of injecting cortisone near the flexor tendon sheath. These treatment measures are successful in around 60 to 70 percent of all sufferers. If surgery must be performed, the surgeon widens the flexor tendon sheath with an incision. Surgery is usually performed when the patient has been suffering from the symptoms for months and conservative therapy has been unsuccessful. If Dupuytren’s disease is present, the surgeon removes the connective tissue nodules or reduces them by irradiation.
Outlook and prognosis
With extensor inhibition of the fingers, the patient experiences extremely severe limitations in everyday life. As a rule, ordinary activities can no longer be performed or are associated with extremely severe pain. The patient’s quality of life is reduced by extensor inhibition of the fingers. The further course and treatment of the disease strongly depend on the cause. If the extensor inhibition occurs primarily after physical or strenuous work, this work must be restricted. In most cases, the symptoms then disappear again, even without medical treatment.In some cases, surgical interventions or massages are necessary to eliminate the symptoms. Likewise, medications are used to prevent or fight inflammation, if necessary. This can prevent further complications and discomfort. Medications containing cortisone are also used. It may be necessary to repeat the treatment after a certain period of time if the symptoms recur. Even after treatment, the patient should avoid heavy exertion and exertion. Life expectancy is not affected by the stretch inhibition of the fingers. If there are psychological complaints due to the restrictions, they can be treated by a psychologist.
Prevention
The best preventive measure against extensor inhibition is considered to be the avoidance of excessive finger strain. On the other hand, it is much more difficult to prevent Dupuytren’s disease. Thus, the exact causes of the disease are still unknown.
What you can do yourself
In everyday life, the stretch inhibition of the fingers is not necessarily perceived as restrictive. It should be noted here that there are courses with or without pain. Grasping, touching, feeling can also succeed well with slightly angled malposition of individual fingers. Therefore, the affected person should not allow his or her movements to be inhibited in any way. On the contrary, a behavior to protect the hand only costs further quality of life, but effectively brings no cure or relief. What can be advised for self-help are regular massages of the hand as well as ergotherapeutic measures. It is advisable to perform finger gymnastics, grasping exercises and loose shaking of the hands. However, strict care should be taken not to exceed pain thresholds during the exercises. Kneipp baths for the arms and hands can also bring about improvement. Only as the disease progresses is it likely that the functionality of the hand will be disturbed. The sufferer notices this at the latest when objects can no longer be gripped properly. Then, but of course also if pain occurs as an accompanying symptom, professional help should be sought immediately. The family doctor can initiate quick measures for treatment.
