Trigger thumb

[Ammon]

About 6 months ago, my left thumb developed a 'catch' when extending or flexing. I looked it up, talked with Dr. Mom, and discovered this is a 'trigger finger or thumb'.

The 'catching' has stopped, but it's painful, won't bend as far, and now there's a nodule on the palm side at the base of the thumb. I watched the video on this site and sure enough, it seems as the problem will require a steroid injection and possibly surgery.

With a family history of diabetes, while I haven't been diagnosed myself, should I consult with my primary care physician for a diabetes test prior to seeing a hand specialist?

Thanks!!

[mtomaino]

Thank you for your question. In short, absent other issues that might make you worry about having diabetes such as: frequent urination, excessive thirst, extreme hunger,unusual weight loss, increased fatigue, irritability and blurry vision--the mere fact that you have a trigger digit probably does not warrant a special trip to your internist to check for diabetes.

Trigger digit is not all that uncommon, and can be successfully treated with a corticosteroid injection in the office. Most of the time, 1-2 injections work---but there is some data that suggests that the "injection approach" is less successful when diabetes is the cause.

In my practice I generally try 1-2 injections, even in patients with diabetes---because it can work. The only caveat is in patients with diabetes who have a problem with cortisone---increased blood sugars for example. In these cases I am more likely to recommend surgery earlier.