The term rapid finger, snap finger or tendovaginitis stenosans refers to a phenomenon in which, due to thickened tendons or a thickened tendon sheath, the finger is restricted in its freedom of movement. Since, as a result, the finger can only be stretched with external assistance and, moreover, bending is also only jerky, the disease has been given the figurative name “fasting finger“.
What is a fasting finger?
The severe form of fasting finger is a movement-restricting disorder of a finger that often has genetic causes. This inherited condition causes swelling of the tendon sheath. As a result, the flexor tendon of the finger can no longer slide smoothly through the ring ligament. Since the tendon can thus be held up by the ring ligament, flexion and extension of the finger are only performed in a jerky manner. Often, the fasting finger is also accompanied by pain. As the disease progresses, the finger’s freedom of movement becomes increasingly restricted. Women are usually more frequently affected by fasting finger than men. Typically, the disease occurs in middle-aged women. Children, on the other hand, are relatively rarely affected by fasting finger.
Causes
One cause of fasting finger is genetic predisposition. In this case, the fasting finger is already recognizable in childhood. Frequently, the thumb is then affected. This is also referred to as a congenitally curved thumb. In addition, a fast finger can also be a concomitant of diabetes mellitus. Other diseases that can cause a fast finger are amyloidosis or rheumatoid arthritis. Similarly, a fasting finger can be caused by tendonitis or carpal tunnel syndrome. Tumors are rare as a cause of the disease and can cause the fasting finger if they occur on bones or tendons. Also, taking medication causes the symptoms of a fasting finger only in exceptional cases.
Symptoms; complaints and signs
In the case of a fasting finger, there are usually fairly typical and clear signs, as the entire [movement restrictions|movement is very limited]]. Often, the affected finger can no longer be stretched properly, as this causes a stabbing pain. Even at rest, a fasting finger caused severe pain, so a visit to the doctor should not be put on the back burner. Those who decide early for a treatment at the doctor can count on a quick elimination of the occurring symptoms. Within a few days there should be a significant improvement. However, those who decide against such treatment must expect considerable complications. The pain on the affected finger increases considerably, so that even small movements will cause severe pain. In addition, there may even be severe swelling on the finger, which will be visible to the naked eye. Anyone suffering from a fasting finger should immediately consult an appropriate doctor. Only with medical or drug treatment can the existing symptoms be alleviated or eliminated. In addition, only with the right treatment is a complete and timely recovery possible. Otherwise, the symptoms that occur will intensify and worsen considerably.
Diagnosis and course
One sign of fasting finger that can be diagnosed as early as the clinical examination is the decreased range of motion of the affected finger. In this regard, problems with stretching are usually more pronounced in the morning and decrease as the day progresses. Frequently, the fasting finger is accompanied by pain during stretching. In addition, with each “jerk” of the finger, a corresponding noise may occur as an acoustic indication of the fasting finger. Furthermore, the thickening of the tendon sheath that causes the fasting finger phenomenon is often palpable above the knuckle. Following the diagnosis, the patient is further examined for diseases that may have triggered the symptoms. An x-ray can rule out other causes of the fast finger.
Complications
A fasting finger initially causes severe pain. If the movement disorder is not treated, chronic symptoms may develop.In general, a jumping finger represents a severe restriction of the hand’s ability to move. Accidents and falls may occur if the finger “jumps” unexpectedly. Rarely, this leads to inflammation of the tendon sheath and nodular thickening. Occasionally, this also results in circulatory problems and other complications. In cases of prolonged illness, the snapping finger usually also affects the psychological condition of the affected person. In the majority of cases, the snapping is eliminated by surgery. However, if the snapping finger has been present for some time, a reduction in extension may remain. In osteoarthritis patients, the operation may have to be repeated or the symptoms may not be resolved with surgery. In general, complications such as severing a finger or thumb nerve may occur during surgery. Swelling and bleeding also pose a risk to the nerve. The use of pain medications is often associated with side effects. Allergic reactions to the agents and materials used cannot be ruled out.
When should you see a doctor?
A doctor should be consulted for this condition. There can be no self-healing in this case and the disease significantly complicates the daily life of the affected person. Therefore, to avoid further complications, a doctor should be consulted at an early stage. A doctor should be consulted if the affected person suffers from severe pain in the fingers. This pain occurs even at rest without any particular reason and can also spread to neighboring regions of the body. Furthermore, the fingers are not infrequently severely swollen, so that the affected person can no longer move them properly or perform any work with them. A doctor should be consulted especially if these complaints do not disappear on their own and persist over a longer period of time. A general practitioner or an orthopedist can be consulted for this condition. Further treatment then depends on the severity of the complaints and is carried out by a specialist.
Treatment and therapy
In the treatment of fast finger, the physician has the choice between conservative methods and surgical intervention. The appropriate treatment method is selected in coordination with the causes and the severity of the disease. For example, a mixture of an anesthetic and a decongestant is a more conservative course of treatment. This is usually chosen for the milder form of fasting finger. The physician injects the preparations directly into the tendon sheath so that they can act locally. Used in this way, they relieve pain and reduce swelling of the tendon sheath so that the tendon can slide easily through it again. In the case of more severe forms of fasting finger, surgical intervention is necessary, since anesthetics and decongestants can only reduce the symptoms, but not alleviate them completely. In this procedure, the doctor opens the thickened tendon sheath so that the tendon regains more freedom of movement. Because it can be performed quickly and is minimally invasive, this fast finger surgery is performed under local anesthesia.
Prevention
While the hereditary form of fasting finger cannot be prevented, early recognition of a metabolic disease that triggers it and its therapy may be able to reduce the occurrence. Overloading of the tendon sheath can be counteracted by avoiding one-sided movements and incorrect stresses. Thus, regularly performed finger gymnastics can also help prevent a fasting finger.
Aftercare
If the fasting finger is treated surgically, follow-up care is necessary afterwards. Because the procedure is performed on an outpatient basis, the patient can return home afterward. To prevent adhesions or adhesions of the flexor tendons or finger joint contractures from occurring, the treated finger should not be loaded too soon. However, slight movements are certainly desirable, which also depends on the individual pain situation. An important measure after the surgical intervention is elevating the affected finger. This reduces pain, swelling and secondary bleeding. To combat the pain, the patient usually takes ibuprofen or diclofenac. In the acute phase, novamine sulfone can also be administered as prescribed.One day after the operation, the wound and the dressing are checked in the doctor’s office. Further dressing changes can also be performed at the general practitioner’s office. After 12 to 14 days, the stitches are removed. After that, it is no longer necessary to apply a bandage. In cold water, the patient performs exercises with his fingers. Exposure to cold can reduce the pain. Thus, the cold water has a soothing effect. If cold water is not tolerated, lukewarm water can also be used.
This is what you can do yourself
Fasting finger, also called snapping finger, is harmless but very unpleasant. A nodule on the tendon prevents the tendon from sliding smoothly through the tendon sheath, or the tendon sheath itself is too tight. The feeling of having lost control of the finger in question is particularly disconcerting. If the finger is not yet completely blocked, the treating physicians will prescribe anti-inflammatory preparations, such as cortisone. Alternatively, hand surgery is an option, in which the thickening is removed and/or the tendon sheath is widened. This operation does not involve any major risks and is successful in most cases. However, the affected patient can do a few things himself to calm a fasting finger. Orthomolecular physicians advise taking a high-dose enzyme preparation to reduce inflammation and make the tendons and tendon sheath more supple. High-dose enzyme preparations are available over the counter in pharmacies, but they are not cheap and must be taken for several weeks before success can be determined with certainty. Not all health insurance companies cover the costs. Another anti-inflammatory measure would be to change to an alkaline diet. For this, meat, fish, sausage, cheese, cereals, sugar and alcohol must be avoided as far as possible. Instead, fruit, vegetables, salads, and soy and whole-grain products are recommended.
