Trigger...hands? Advice please!
Hi all,
I've been taking arimidex since Jan of this year. I've had the usual hip/joint pain, cracking joints, etc, and I can live with those. The hot flashes are minimal because I take low-dose effexor.
What I need help with are multiple trigger fingers and thumbs. I can barely use my thumbs and many of my fingers (ring finger in particular) in the morning because the joints catch and won't straighten all the way. When they do "pop" open, it hurts!
My MO and I both have agreed I'm committed to arimidex: it's been used and tested longer, and she believes for my dx it's better than femara. I also know that experiencing side effects is a good thing, according to a Brit study that found that women who experience SE from this drug have a bit of a lower recurrence rate. But how do you all help yourselves with this problem? I can hardly hold a coffee filter to make coffee in the a.m. much less do housework, keyboard, etc.
Any ideas? I'm on arimidex till for at least 3 years or more...it appears.
Thanks! Happy 4th!
Claire in AZ
Comments
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Hi Claire,
I took Arimidex for a bit more than 2 1/2 years. Trigger finger was not one of my se's. Hopefully, the se's will get better, as they do for many. Do you take any supplements to help with joints and inflammation? At various times, I have taken glucosamine/chondroitin , boswellia and curcumin. I think they helped a bit. Ask your doctor about trying them. Take care and I hope you find some relief soon.
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Claire,
I had troubles with fingers mildly triggering on arimidex, then I switched to aromasin because of a different SE. After a year I developed severe trigger thumb in my dominant hand. It was so bad I had to have a cortisone shot. Working so far and the other thumb has calmed down.
Several women have had trigger troubles for several months, then they disappear. Sometimes they will take a short AI vacation to see if the SE will go away. Or switch meds. The goal is that you find one that you can stay on w/o causing serious QOL issues.
The suggestions above are good. Also try putting your hands in warm water immediately when you get up in the morning before straightening. I also wore arthritis gloves at night, though with the seams on the outside. This helped also.
I'm sure others will come with more suggestions.
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Oh Claire, I so feel your pain. I wore these gloves during my femara years (maybe these are the ones doxie's talking about?) They helped a bit, not a whole lot on their own, but I shoved ball bearings into the tendon areas in the gloves and that pressure eased the pain. The thumbs were the worst for me.
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Claire - I had this happen on both Femara and Arimidex. I had issues particularly with the thumb on my dominant hand. I got a lot of relief from taping. It allowed me to immobilize for the most part, but I used flexible tape so I could still use my hand, and I slept in it. Here is the tape I used - it is the stick to itself stuff and I wrapped it two or three times around. I found it at CVS and used the flesh colored one. It took a month or two to work well, but it did work. I have no issues now and no longer tape it.
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First, confirm with your doctor that this won't interact with your meds (I'm on Tamoxifen and it is ok). When my mother had a trigger finger, she was close to surgery to "fix" it by cutting a tendon. Her doctor told her to try taking Rhus Tox, little pellets like Arnica, to see if it would help. Completely fixed her trigger finger and no surgery was needed. I take it when I have arthritis flares and it helps shorten the duration.
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I have trigger fingers and thumb on my right hand. I was on Armidex but have switched to Tamoxifen. I sleep with compression gloves and wrist splints. This spring I got cortisone shots in my hand and they are better. It took two times to get relief for more than 3 weeks, but it is going on 2 months now and they are still tolerable. I also take glucosamine, omega 3 and vitamin C supplements. The warmth really helps. I also still go to PT every other week to get hot wax treatments and some exercises and massage. But I also have very stiff little fingers and can't really make a fist. To keep them from triggering before the shots I would tape them like SpecialK, but I don't need to tape anymore.
My MO said I'll stay on the tamoxifen for awhile and see how it goes. She did not want me suffering and end up not taking anything. I am also on Pristiq (brand name of effexor) to help with se.
Hang in there and communicate with your MO. Maybe she would order some PT?
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Like some of you, I have severe trigger thumb on my prominent hand. It is worst when I wake up in the morning. Hurts like hell when it pops up and down. I am on many supplements like glucosamine chrondrotin but it doesn't help, vit d, calcium,etc. I been on anastrozole (arimidex) for more than a year. The joint pains are also a problem with my knees and ankles also including bone pain. I have osteoarthritis in my knees and ankles however because of a bleeding issue, I can not take any NSAIDs or anything that thins the blood. I was also recently diagnosed with osteopenia. Not willing to change my meds yet. So, if someone comes up with a solution, I hope it works for me, too.
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Hi Claire....you might try tonic water which seems to work for cramping. I have been lucky to avoid most of this, but others seem to have had good luck with it. Adding gin is optional, although not recommended at 10 AM. As for general cramping, I find I am a lot happier if I eat more salt than is usually recommended. So something like potato chips, and I'm good.
Feel better, and I suspect that getting ENOUGH electrolytes in your body is especially important during the summer in AZ.
As a bit of good news, I got the 5 year "all clear" yesterday. I am elated, and yes, it's champagne for me. - The Northern Claire
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Claire, when all my cancer treatments finished and some time had past, I developed trigger finger in my thumb. It came and went, but was worse in the morning. After a bit, my ring finger was acting up too. I was on Tamoxifen for only a few weeks and stopped permanently, so I'm pretty sure it wasn't from that. I went to a hand doctor and he gave me a shot in the two fingers. It felt great, took the pain away, but after about 3 months the pain came back. We tried the shots again, but I was told if it didn't last and if the fingers didn't heal themselves then surgery was the way to go.
After another 3 months the pain came back and I had enough. The pain was wearing me out and even though it wasn't my dominant hand, I picked surgery. About a week or so before my surgery date, my middle finger started to lock too. I was hesitate, but I asked him to just take care of all three while I was out. It's hard to say if the middle was going to be as bad as the others, but I wasn't taking chances. All three fingers healed great and as much as I hated going through surgery it was worth it I believe I was 47 or 48 at the time and cancer had already robbed me of enough months. I wasn't going to let my hand rob me of any more. Feel free to PM me if you want to know more. I am familiar with AZ.
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Small correction to a post by macatacmv. Pristiq is not the brand name for Effexor. They are very, very similar but Effexor is venlaxafine and Pristiq is desvenlaxafine (essentially the same drug). Desvenlafaxine is the active metabolite of venlafaxine.
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I hear you! My Dr is saying my cold hands and trigger fingers and cold, numb, and burning feet is from the Chemo I had last summer (ended August 15)...not the Femara I started last Sept. My triggers started in Dec. I even went off Femara during April and saw no difference. They said the Chemo side effects will have to be lived with. That after a year...whatever you have, is there for ever. They don't seem concerned...but, it's not them setting there with burning feet and cold, numb trigger fingers!!
I hope you find some help. I am going to check out the Rhus Tox that someone posted about. (Thank you).
Retta
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After a year on Arimidex, I had horrific trigger finger (middle finger) and trigger thumb on my right hand. Every morning the pain was awful, and I kept dropping things because they locked so hard. My hand looked like a claw. One doc mentioned surgery, but there was no way I was going to get a permanent procedure for a temporary side effect caused by a drug I was taking.
I quit the Arimidex, and in 8 weeks, ALL my SEs (I had a huge long list) went away.
Then I started Femara. The trigger thumb never came back, but the middle finger did.
At first I used a foam tube usually used on toes (that you cut to size.... I kept it finger length). And on top of that I wrapped one of those metal splints lined with foam. My finger was totally immobilized! That didn't help either.
I stopped the Femara a month ago. I still have mild trigger finger, and I treat it in much the same way that Special K does, except that I rub the entire finger with Aspercreme for the pain, wrap some stretchy gauze around it, then secure the gauze with paper first aid tape. It's stiff enough to keep the finger from bending all the way, but loose enough to still have a bit of movement. That has helped with the pain more than anything.
If I still have the trigger finger in a month, I'll consider the cortisone shots, since I'm off the AIs completely.
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Wow, thanks for all the posts. Seattle Claire, happy dance for you! Ha ha about the gin. I hope I don't have to start doing that. Tonic water for trigger fingers? Do you soak them in it or drink it?
I'm in Northern Arizona, so I don't have to worry about heat and lack of electrolytes although I use Powerpack (like Emergen-C) recommended by my yoga instructor post-bikram. In No. Az we don't even have AC in our homes; it never gets above 92-93 and that happens for just a few days before our monsoon season sets in.
I'm interested in the cortizone shots as well; I've had them for elbow tendonitis and it worked permanently.
SpecialK, how exactly do you "wrap" your thumbs, or how did you? Did you leave the wrap on all day or sleep with it just at night or...?
Finally, Rhus Tox...is this a homeopathic remedy that I can buy at my natural food store, or do I have to order it?
Keep the posts coming; it helps to know I'm not the only one who suffers from this. I am constantly pulling on my finger and thumbs to "crack" the joints; the left thumb now can't straighten at all.
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Claire - my triggers all resolved - don't currently have any. I found that different brands of AI can cause different SE too - so you might want to switch brands. I cut a fairly short piece of the tape - depending on the height I also cut it lengthwise, then wrapped the digit about 3-4 times around, more if you want less mobility. The tape will stick to itself. It served to immobilize enough that it didn't hurt or pop, but because the tape was stretchy enough I still could use my hand. Here is a pic of what it looked like with a piece of tape that is just over an inch tall and about 6 inches long:
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Read the label on the potato chip bag if you eat chips for the salt. The majority of the salt is potassium not sodium on a lot of brands. Still tastes salty. Shop around for a brand that doesn't use as much potassium unless that's what you want.
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Okay, I think I'm being stupid on the tape (but I have plenty of first aid equipment like that--two surgeries and a plastic bag full of things that my PS keeps giving me!). What exactly does taping do? My thumbs aren't sore except when I "pop" the joint open....and is it better for overall mobility than using nothing? I'll blame my lack of understanding on chemo-brain...
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I was not instructed to do this, and never consulted any docs about this problem other than mentioning it to my onc. I decided on my own that the finger was more comfortable if I could prevent the pop. I assumed that I had inflammation in there so immobilizing it might calm the inflammation and prevent the pop if I bent the finger (thumb). By taping I could keep the finger straight, keep it from the pop, but still bend it enough to function - this was my dominant hand.
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I tried taping my thumb, the fingers were only a minor issue. I used a flexible waterproof tape. It was helpful in limiting the pain I had whenever the joint bent either direction. Unfortunately I have to constantly sign documents so I'd still have to bend it. Finally I left it bent, didn't tape except for over night, and the pain was more tolerable. Only the cortisone shot helped. That was done at the base of my thumb which is where that actual problem is.
You'll probably have to experiment to see what works best for you.
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FWIW - at the time of the first trigger I was on Femara, I taped for a bit and then switched to Arimidex. The trigger resolved - I will never know if it was from the taping or the drug change. After a year on Arimidex I developed a trigger in my wedding ring finger, a toe, my left ankle, and my right knee swelled and became hot and painful. I ended up with a cortisone shot in the knee, but at that point I switched back to Femara, since that is the drug my onc preferred. I figured if I was going to have this problem I would rather it be on the drug he wanted me on. I filled the Femara prescription, but it was a different manufacturer. I have yet (knock on wood!) to develop a trigger, and it has been a year. I also went on an anti-inflammatory diet and have no more joint pain either.
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I just got back from Bikram yoga....my hands are stiff, and my thumbs still pop, but it doesn't hurt when they do. The stretching and heat/humidity in the practice room helps, I think.
I don't want to take glucosamine yet, or add extra ibuprofen--I'm paranoid about liver enzymes and blood tests, and both those things can make them increase. I'm still on the 3-4 months MO visits, and any little glitch in my testwork FREAKS me out.
The hot water this a.m. first thing helped a bit too. i wonder if anyone believes that low pressure might make the swelling/catching/pain worse? We are in our monsoon season, and the pressure is lower than normal, and more humid in No. Az this time of year too. Any thoughts on that?
I can barely get my rings on, because my knuckles are swollen.
Thanks again all. You're fabulous support!
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I am on Tamoxifen since early December and also had TC chemo which ended in November. Since December, I have developed trigger thumb on left hand and carpal tunnel in right hand. When EMG confirmed carpal tunnel, it also showed cubital tunnel in elbow. Since these are affecting my job, I am having the wrist and elbow surgically corrected at the end of next week. Cortisone shot has the trigger thumb 80% better for now. I actually logged on to post something to see if anyone else has had similar problems. I also have lumps after my fat grafting which biopsy showed to be inflammation. Not sure what's with all of this inflammation, and I am hoping to find something that helps to keep it at bay.
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I am considering the cortizone. My husband has to have a meniscus repaired soon, and we have a great relationship with our osteosurgeon, who's worked on both of us before
I think I'll talk to him about it when we next see him; maybe he'll give us a two-for-one deal.
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I think the taping to reduce the movement in the affected finger/thumb is not to take away the pain of popping, but rather to immobilize the joint as much as possible to remove inflammation.
It's possible to still have a node on the tendon without horrific pain, as long as inflammation in the rest of the finger and the joint has been reduced.
When I tape, it's usually just at night, because as soon as I get up, I'll have my smoothie ingredients all over my taped finger if I don't take the tape off!!!
And in my case, using the anti-inflammatory cream, covering it with gauze, and then taping serves two purposes. It occludes the skin, allowing the medication to seep in deeper into the tissues, and partially immobilizes the joint to allow it to rest and let the swelling go down.
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Rhus tox is homeopathic. I get mine from Whole Foods, but you can also find it at The Vitamin Shoppe and Amazon. Any store that carries Boiron will normally have it. Hope you find some relief soon!
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I have a Whole Food store, so I'll try. I taped yesterday--the most affected thumb--and it seemed to work. Now I have both thumbs taped and they seem better. I'm using the plastic tape that sticks to itself but not anything else, so it's great: I can re-use it. As I said, yoga helps a lot but I can't go every day, so thanks for all the tips. I'm committed to staying on arimidex for the duration of tx.
I will also try to switch to another brand. Will the pharmacy or my insurance fight me on this?
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Claire - I fill my Rx at CVS and they usually have one manufacturer in the store but several in the warehouse. It takes a couple of days to get it but it does not cost more for me. I discovered that the manufacturer I am currently using caused less SE totally by accident, it was the regular formulary when I switched back from Arimidex to Femara. They filled it with that manufacturer for a few months, then switched to a different one but still carried this one in the warehouse. I don't think there is a significant price difference among the generics. I keep asking for the Teva one because I don't want to mess with success!
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UPDATE: Just got a cortizone shot in the base of each thumb day before yesterday. Ouch. But it seems, after two days, I've got some relief. The joint on the worst thumb (the left) still catches, but when it "unhooks" it doesn't hurt like h*ll as it did before. The MD told me that the shots often can cure this issue completely (thumbs crossed ha ha) and that thumbs are easier to treat for trigger finger than other fingers.
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I hope the relief from the cortisone injections lasts so that you can avoid surgery. I am getting a trigger thumb release on Tuesday now that my carpal tunnel and cubital tunnel on the other side are healed enough to function. These inflammatory conditions are for the bitds!
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claireinaz - Seriously? The shots might be able to actually cure the trigger finger? Oh, I hope so for you!!!
I've been using NSAIDS and conservative methods (splints, wrapping, etc.) for months now with no improvement. I've pretty much made up my mind to go get a cortisone injection in the base of my middle finger on my right hand.... that's the only place I have pain. When the finger locks, I can unlock it with the other hand with no discomfort.
The only thing is, I am a big weenie! I let my podiatrist give me a cortisone shot in the middle of the bottom of my heel when I had severe pain there (NOT related to my plantar fasciitis) and on a pain scale of 1-10, that was a 40 or 50. I was sobbing and begging him to stop, but he didn't. Thank goodness I really love this doc, or I would have beaten the snot out of him afterwards. Even DH almost passed out, and he was just watching! (The shot DID work, though...)
But I've had cortisone injections in muscle spasms in my back, and those weren't too bad, so maybe the finger shot will be more like that? (ohpleaseohpleaseohplease)
Who gave you the shots? Your PCP or a Hand Specialist?
~ ~ ~
KBeee - prayers for a quick and successful procedure on Tuesday! My trigger finger is on my right hand.. where I've already had a carpal tunnel release and a ganglion removal. Will be interesting to hear how your procedure went.... when you are cleared to get back on the computer, of course!!!
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I was given a cortisone shot for a trigger thumb in April. I had instant pain relief because the shot was preceded by lidocaine.
Request the lidocaine first and you won't feel the cortisone shot. Otherwise I see how painful it would be.
It took a month for my thumb to regain full function, but it is great now 4 months later. No hint of the problem returning.
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