I'm on Femara and my hands are getting crippled?

I'm only about a month into Arimidex and haven't had joint pain yet. But as a gardener, I can tell you that jalapenos vary in heat from season to season, plant to plant and time of harvest. Most jalapeno lovers I know agree it's the luck of the draw, whether you're picking them from your own plants or buying them from a store. So your reaction may, or may not, have been related to Femara. Best wishes.

evjaq - I was on Arimidex for a year, and stopped when the SEs got so bad. One of the first to appear was trigger finger (middle finger on right hand) and trigger thumb (right.) At first my hands were so stiff in the morning I couldn't make a fist. Later, with the trigger finger, I woke up with my hand painfully bent into a claw shape. I'd have to unbend my fingers with the other hand.

My MO told me to use an anti-inflammatory (sparingly), wear a night splint, and massage my hands and fingers well before going to bed at night.

Unfortunately, I think it's a pretty common SE of this family of drugs. Since being off the Arimidex I'm doing so much better, but I start Femara on Monday.

What does your MO say about your hand pain?

Can't address the jalapeño issue, but my PCP was ready to send me to a Hand Specialist if I didn't get better. You might request one to see if they can offer you any relief.

I got trigger finger in 2 or 3 fingers after just a short time on Femara. I started taking 1/2 a pill a day and have been on that for 3 years with no further issues. Most of my joint pain has gone away. It was that or I was going to quit taking it. Best wishes!

just so you know...I switched to 1/2 a pill a day on my own. My MO was not in favor of it. However he realizes quality of life is a big deal, and didn't try to talk me out of it. I did try going back on a full pill after a year or so. The side effects returned quickly. Good luck as you navigate these waters!!!

Any hope for me? I've had a trigger thumb for several months from Arimidex.

I've had several "mystery injuries" since starting the AIs. My MO wants me to take the full 5 years, occasionally offering up an "AI holiday", which never helps. Switching from Femara to Arimidex helped early on, but in my 2nd and 3rd years the AI has been rough on my body.

I've treated all these "injuries" with home measures after seeing my doc. However, I never treated my trigger thumb very aggressively. I'll think it's a bit better for a while, then boom, ouch again. Oddly enough, while on an Arimidex holiday recently, it got worse, so I just started back up on the Arimidex. My foot tendinitis resolved (my bigger dog stepped on top of my foot), but not the trigger thumb.

I never did splint the trigger thumb, as my family doc didn't suggest it. He said ice and rest. I've had it now for several months on and rarely slightly off, and I believe the doc's next suggestion will be a specialist and cortisone injection. His nurse mentioned that some people get surgery, but I'm terrified of anesthesia and, more importantly, why have surgery just to find out you get trigger finger or thumb in another hand? These AIs never stop.

Is it too late for more icing and a splint or other measures? What has worked for you? I try to massage it when it really hurts, but that doesn't work. I'm unable to take anti-inflammatories long term because they cause rebound migraines. I've had chronic daily migraines diagnosed for 15 years and have to medicate judiciously.

Any ideas or words of hope? It's my dominant thumb and really stops me from doing things. Thanks.

Dawnsm - Yes, my primary care doctor gave me splints for both my trigger finger and my trigger thumb - unfortunately, both were useless. The finger splint was one of those metal ones with a foam lining that you squeezed around your finger. That was awkward and painful to wear at night and caught on the sheets.

What I got for my thumb was a "thumb spica" splint, which looks a bit like a splint for carpal tunnel. That didn't work either, as it didn't immobilize my thumb enough.

What I ended up using as a finger splint was a foam tube I got that was made to cushion toes. (You're supposed to cut it into smaller lengths.) I left the tube whole, and slid it over my whole finger. I could barely move my finger, but it was very comfortable to wear at night.

As for my thumb, I wore nothing. However, had I followed up with the doctor and requested a referral to a Hand Specialist, I'm sure they would have had dozens of braces they could have ordered for me.

As a long time sufferer of carpal tunnel syndrome, I can honestly say that yes, you CAN make your trigger finger worse at night, depending on the position you sleep in. If you sleep with your hand curled into a fist, then it will be much harder to uncurl it in the morning.

The most important thing with trigger finger and trigger thumb is to rest the hand. Is yours on your dominant hand? Most are. The goal is to reduce the inflammation as much as possible. There is a nodule on the tendon that gets inflamed, and that bump gets caught inside the joint as you try to bend the finger or thumb. The longer it stays inflamed, the harder it is to cure.

The first step is to reduce the inflammation. Since you can't take the oral NSAIDS, you can get a cortisone injection. The injections usually work, but you can't have them too often or too many times as they can lead to complications, and weakening of the tendons. Surgery is the last resort, and one I wouldn't consider at this point.

In addition to wearing a good splint at night, you can soak your hands in hot water in the morning to reduce the stiffness and make it easier to move your hands. And yes - DO massage and stretch your hands and fingers on a regular basis!!! Those stupid nodules tend to make us use our hands less, and then the stiffness sets in.

I've had major wrist injuries, lots of hand therapy and one hand surgery in my pre-BC years. I really do think it's worth it to visit a Hand Specialist, as they can give you the best orthotic devices and specialized thumb and finger exercises.

Hope you find relief soon!!!

p.s. I still get the trigger finger a few times a week, but the trigger thumb happens less frequently. I took a 2 month break from Arimidex, and started on Femara last week. We'll see. :-O

ev - I have taken Glucosamine and Condroitin, but now take Schiff Krill Oil Joint Formula, and Dr. Joints. Here is a link to the kind of tape I used. I applied it tightly enough to basically immobilize, but not cut off circulation. Some rolls were pretty wide so I had to cut it in half lengthwise for it to fit my thumb - I only needed 5 or 6" each time I wrapped it. The link shows purple but it comes in a more neutral color as well.

http://www.drugstore.com/products/prod.asp?pid=140255&catid=184301&aid=338666&aparam=44544747168id140255&device=c&network=g&matchtype=

blessings - whack it with a bible - sheesh! The tape was an excellent solution for me - and inexpensive. I was willing to try any non-invasive idea as I have lymphedema in that arm so not wild about either cortisone injections or surgery on that hand. The biggest annoyance was that washing my hands got the tape wet so had to re-tape a lot. Being such an allergic person myself I understand why you would avoid the supps - I am currently dealing with a steri-strip nightmare from a skin cancer surgery last week. So far none of the supps I take have caused issues - just tape of all sorts and antibiotics - surgery is a challenge for me!

joan888 - I started on Mylan generic letrozole (Femara) and had the trigger within 6 months , along with aching - switched to generic anastrazole (Arimidex) and had trigger issues, a knee that reqired a cortisone injection, had aching the whole time. When I switched back to generic letrozole I received Teva - much better - far less aching, and so far no triggers. The ones I had on Arimidex have resolved on their own. I agree that either trying another brand of generic, or going onto the original name brand drug (with help from the onc with a scrip for "name brand only - patient allergic") can make all the difference. Among the generics for any of the AIs there are different filler ingredients used and can cause all sorts of side effects.

gentian - I had experienced trigger fingers and thumb, then got a toe and ankle - the ankle was so painful that I could not walk on it - interestingly if I put on a heel it hurt less. I guess it changed the arrangement in the ankle with regard to the tendon. Some days it bothered me, other days not. This was the left ankle, and right knee needed the cortisone injection - so I had a few days where walking at all was a challenge, lol! When I went for the check on the knee, the ankle had mostly resolved (after I switched from Arimidex back to Femara) but I asked my ortho about this and he said yes - you can have a trigger in a larger joint. I think the mechanism is the same as in a digit - it is a problem with the tendon and the joint, so anywhere you have that combination could be susceptible. However, you could also have carpal tunnel or a ganglion in the wrist.

gentianviolet - like SpecialK said, yes - you could have a "trigger wrist" or any other joint in which irritated tendons must move through a narrow sheath.

But is your wrist just painful? Does it hurt when you move it? Or does it actually get "stuck" in a certain position, and you have to physically move it to release it? Is there kind of a "thunking" (sophisticated medical term!) sensation when it releases?

If it's not getting stuck in any particular position, then it may not be "trigger" wrist. For any of the myriad orthopedic problems we can get in our joints, the treatments are usually the same to start: Rest, ice, anti-inflammatory meds.

You might try a cheap wrist brace, like a carpal tunnel splint, to see if that helps. If your wrist hurts more in the morning, try wearing the splint at night. Put towel-wrapped ice packs on the wrist for 20 minutes at a time throughout the day. Take an NSAID (Motrin, Aleve, etc.) if you can. Try to not use your wrist, but don't keep it immobilized, either. That can cause a whole different set of issues.

As always, if the simple things don't work, by all means contact your doctor!

dawnsm - I pretty much kept it wrapped 24 hours a day, other than bathing. I had the same problem with inadvertently causing pain, when without the wrap, because it was my dominant hand. I probably kept it wrapped for a couple of months and I did wrap it fairly straight. I just cut a 5-6" length of the tape and wrapped it around just the thumb, secured to itself. The tape is stretchy so it will allow the thumb, or finger, to bend a bit but not enough to get stuck and need to pop back. I figured that isolation would allow any inflammation to calm down. Keep in mind, this was my remedy - this was not advised by any physician.