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Trigger Fingers from Taxol?

Gardengal
Posts: 8
Joined: Mar 2004

Has anyone experienced trigger fingers as a result of chemotherapy? I had four doses (dose dense) of A/C, then 8 doses of taxol(once a week) Completed chemo 11/19/03. About a month later, I noticed that my fingers were "locking" (trigger finger) At first, I put it off as a side effect of the Taxol--we all know that it affects nerves in hands and feet. However, it's now late March--the thumb on my writing hand will no longer bend. My oncologist says she's never heard of this symptom, my primary care sent me to hand surgeon. I suspect the chemo as it happened to most fingers at the same time. No traumatic event and I don't do anything repetive. Any guesses?

tlmac
Posts: 272
Joined: Feb 2004

I've never heard of trigger finger being associated with chemo but I have read of instances where it is associated with axilary node dissection associated with breast cancer. I believe it happens to the hand of the affected side. This article discusses the phenomenon:
http://www.uphs.upenn.edu/ortho/oj/2001/html/oj14sp01p35.html

Gardengal
Posts: 8
Joined: Mar 2004

Thanks for the suggestion. I have just read the article. Although both of my hands are affected, this could be a reason.

live42day
Posts: 64
Joined: Oct 2003

Gardengal,
Funny you should bring trigger finger up. The middle finger on the non breast cancer side started locking up a little over a year after finishing chemo. I had 4 a/c and 4 taxol treatments. The IV for my chemo was always put in the back of the hand that developed the trigger finger. I had a cortisone shot that helped but didn't fix it. Ended up with minor surgery on it Dec 29, 03. This did the trick. I have thought it might be chemo related. Have an appointment with my oncologist and am going to ask him about it.
Janet

Gardengal
Posts: 8
Joined: Mar 2004

Like you, I will probably have the minor surgery on my writing hand thumb as it no longer bends.

DeeNY711
Posts: 482
Joined: Apr 2003

Given a choice, I would pick a consultation with a physical therapist experienced in treating patients who have had breast surgery, chemotherapy, etc. rather than making a surgeon the first stop. When I returned to work, I found fingers on both sides becoming locked now and then. Whether it is from nerve damage or muscle damage related to bilateral mastectomy or to chemo or radiation, who knows? Request a consultation with a physical therapist.
Hugs,
Denise

Gardengal
Posts: 8
Joined: Mar 2004

Thanks for the suggestion, I will certainly look into it. Its comforting to know someone else experienced this same problem, isn't it? You said you noticed the locking when you returned to work,had you finished chemo--or still going thru chemo or what?
Gardengal

DeeNY711
Posts: 482
Joined: Apr 2003

I had finished chemo 6 months earlier.
D.

Gardengal
Posts: 8
Joined: Mar 2004

Mine started a month after. Have you had any additional finger problems since working with the therapist? I'm hoping this is a one time incident.
Gardengal

inkblot
Posts: 711
Joined: Jul 2001

Hi Gardengal:

Yes, it happens. I had the same thing. Mine did not begin until about 4 months post chemo. I had lumpectomy on left side with Sentinel Node dissection. I had A/C chemo and radiation. My problems first appeared on my right side. In my case it was chemo related. My Ortho. doc said it was not uncommon following chemo. My onc. feigned never having heard of it!
Onc's are good at blaming everything EXCEPT chemo! LOL What happens is this, as my Ortho. doc explained it: The chemo irritates the lining of the tendon...called the tendon sheath and inflammation developes. This, in turn, inflames the tendon and there you have it. It can continue to spread. Sometimes, a surgery to scrape the tendon sheath away brings healing but sometimes not and the problems continue about 50% of the time. This same syndrome can occur in the hips and knees following chemo according to the ortho. doc.

I consulted an Orthopaedic specialist. We tried several different approaches for almost a year as I really wanted to avoid surgery. Splinting, heat, etc.. Then cortisone. I had an allergic
reaction to the cortisone injection, so that wasn't an option for me beyond that first shot. Next we went to NSAID's (Bextra). Only helped minimally after a month of taking it. Then physical therapy, which also didn't help. I also take Glucosamine/Chrondroitin w/MSM and I increased the dose, which seemed to help more than anything else. Still it kept recurring.

Initially, my problem was on the middle finger of my right hand. I had periods of improvement and then it would regress again. Always worst, first thing in the mornings. Then the right thumb became frozen and would not bend at the joints at all. At this point the right hand became almost useless to me. The pain became constant. Sometimes the frozen thumb would bump something and snap down and would not come back up on it's own and I or someone close at hand had to push it back up. Doc gave me a thumb splint with metal on the bottom to keep thumb straight but I found it cumbersome and not much of a fix really. I hated constantly wearing the larger, whole hand/wrist splint too. When the frozen thumb would bump into something and bend, when I wasn't wearing the splint, it was excruciating and would then swell and hurt for 2 or 3 days.

Finally, surgery was my only option. A trigger finger release is a very simple procedure...only a tiny incision, but the doc also did the DeQuervains procedure at the same time, (this is done on the wrist area) which cleared up the problem with my thumb at the same time. I'd do it again as the result was immediate and amazing. Worst part of the surgery: Since they didn't want to put an IV into my left arm (surgery side and a no-no, barring emergency) and since it couldn't go into the right "procedure" arm, it went into a vein in my ankle. It was excruciating having a needle inserted into such a sensitive area. When I awoke, it was already removed, thank goodness. Aside from that, healing was quick and complete. No post op pain to speak of and stitches came out 9 days later.

Since that time, (I'm 3 years out now) I get an intermittent, mild snapping in my left middle finger but it's very infrequent, with no swelling or pain...just annoying. Annoying, I can live with! LOL

That you're seeing an Orthopaedic Doctor whose subspecialty is hands, is IDEAL.

Hoping you find something which works, short of surgery, soon, but if not, and surgery is emminent, it's not a big deal. Just an eye blink and it's over. Feel free to email me here if I can be of any further help.

Love, light and laughter,
Ink

Gardengal
Posts: 8
Joined: Mar 2004

Thank you so much for the detailed e-mail! You are exactly right, the oncologist didn't know about it at all. The Hand surgeron didn't either (I am copying your e-mail to show him) but at least he was more open-minded about the cause being related to my cancer treatment. I guess we should trust our instincts, huh? I knew I had done nothing to my hands. As you noticed in my postings, I have heard about the trigger release procedure, and will have that done on my writing hand thumb. Someone else recommended physical therapy, I may look into that, as well since all of my fingers are triggering. However, I may go the "shot of cortisone" route in another finger to see if it works. I have been told by others (as well as you) that the relief is immediate. I am so fortunate that (so far at least) this is my only side effect-a minor imposition compared to some problems.
Again, thank you for taking the time to respond.
Sandi

JHNC49
Posts: 1
Joined: Jul 2011

I finished chemo in 2006 and afterwards got trigger finger in both hands, and on the same finger, the middle one. A bone surgeon told me that he has seen this in cancer patients and diabetics, esp., when it happens with the same finger on each hand. After chemo I broke my wrist and while the surgeon was reparing my wrist he clipped the nerve in my hand that caused the trigger finger and that fixed it on that hand. He only clipped the nerve on one hand since I would need the use of my other hand while my wrist healed. I've been getting steroid shots in my other hand about 2 times a year and it stops the pain of triggering. However, it keeps coming back. I'm going for another shot this week but looks like I need to have the surgery done on the other finger to fix it for good. Looks like the oncologist would know this but it was a bone surgeon who told me that he sees this in cancer patients. Had I not broke my wrist I wouldn't have known that this is normally seen in people who have had chemo, and I had the Taxol also. BTW: By the grace of GOD I am going in my 6th year of survival of lung cancer. My cancer was localized in one area but had to have the entire left lung removed.

Double Whammy's picture
Double Whammy
Posts: 2828
Joined: Jun 2010

Just last week, I seem to have trigger finger in my right middle finger (self diagnosis). I had Taxotere , a cousin of Taxol. Anyone else?

Suzanne

Barb A's picture
Barb A
Posts: 123
Joined: Jun 2009

I've been having a problem with my thumb since early March. I've been done with chemo for three years though.

I'm told this is becoming more common if you use a keyboard and mouse a lot. A man I work with had the same problem with his thumb last year. He's never had chemo, but it was doing exactly what mine does; locking up, painful, etc. He had surgery on the tendon and it is now fine.

I don't know if there is a correlation with chemo, but there sure seems to be a lot of this problem. Good luck everyone.

Barb A

Msgsal
Posts: 1
Joined: Feb 2018

I had surgery on my right thumb several years ago. 

Then my left thumb had trigger finger. It resolved itself. 

Now, 4 months post chemo, I have trigger finger in all fingers (minus the thumbs) 

Has anyone else been this severely affected? 

What do I do? 

lodud93
Posts: 1
Joined: Jul 2020

Interesting to find this conversation - I'd had some trigger issues with my left middle finger off & on prior to finding cancer. I wondered if all the NSAID's & steroids from surgeries & chemo helped that for a while, as it had quit bothering me.  I finished with Taxol/carboplatin in December, and now this spring both hands are stiff & now having issues with right thumb & forefinger worse than the left middle finger.  I also spend 8 hours a day (plus some overtime right now) using a mouse & keyboard, so hard to say whether to blame chemo, job or both. Hmm, come to think of it, I'd also not worked for at least 6 weeks due to cracking my left arm while I was doing chemo, then jumped back in & built up to full time, then overtime & stiff/locking thumb & forefinger. I expect it IS a combination of things . . . have been stalling on going to a doctor about it.

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