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Dr. Andrew Rynne

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How can painful curling up of the fingers be treated in an elderly patient?

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Dr. Saddiq Ulabidin

General & Family Physician

Practicing since :2011

Answered : 2236 Questions

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Posted on Tue, 15 May 2018 in Bones, Muscles and Joints
Question: My wife, age 83, has developed a situation where her dominant hand (left) the index and ring fingers have curled into the palm and those knuckles are swollen . This is very painful with the pain radiating up the arm to the elbow. she has no recollection of an injury but has spinal stenosis following a fracture to the lower back which also causes pain (the kyphoplasty (sp?) failed and collapsed. she also developed anxiety and depression and has a history if arthritis and possibly PMR but is off steroids.
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Answered by Dr. Saddiq Ulabidin 3 hours later
Brief Answer:
She need potent analgesics or nerve blocks

Detailed Answer:
Hi! Welcome to Healthcaremagic. Thanks for sharing your concerns with us. We will try to help you in best way possible. First of all it's sad to know what your wife had gone through.

Based on the history you have shared, surgical options are indeed rare with her comorbodities but a second opinion by an orthopedician can be sought with a fresh X-ray or MRI or the aftected forearm to substantiate the extent of the damage as in some cases it's self limiting and may even settle down in a matter of weeks spontaneously without surgical options with or without any deformity.

With the current symptoms, supportive management is the best approach with potent analgesics. OTC analgesics like acetaminophen or Ibuprofen can he useful but will not be sufficient. She would need more potent analgesia like with tramadol, or nerve pain suppressants like carbamezapine or gabapentin etc.

A pain medicine specialist can be appoached for other long lasting options like nerve blocks etc which can suppress the sensations from the affected nerve ends only sparring the others and can be best with her condition.

Wishing her a better recovery. Hope this has answered your question. If you have any more questions please feel free to ask. Regards.
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