Trigger finger: A true representation of the failure of understanding of the existing medical model to diagnose correctly

Trigger figure is certainly not one of the more common diagnoses I have had to face over my career but it truly exemplifies why the existing model fails at addressing pain in most cases throughout the body. For most people who have received treatment for it, they know what I am talking about.
In the cases I have treated this condition, it always starts off the same. The person notices that when they bend a finger and try to return it to the extended position, it cannot go back. It gets “stuck”. They usually have to move it passed this locked position to get it back to its fully extended position. Sometimes they can force it through the stuck point but this comes with pain.

They see the usual suspect, the orthopedic surgeon. They are told that the cause of the limited motion and pain is that there is a structural variation to the connective tissue sheath that makes of the tunnel that the tendon runs through on its way to the end of the finger. The structural variation is inhibiting the tendon from moving properly preventing the finger from extending fully. Usually there is the precursor to surgery, the cortisone shot performed. Some people will get some short term relief while most get no relief. This sets up for the every popular, there is nothing else that can be performed to correct the situation except surgery. So surgery is performed and within some time frame when activity returns to normal, the trigger finger returns. This has been the common tale I have heard before the person through some means finds out about me and decides to give my method a try. I always hate this idea and why I am desperate to make the Yass method the standard of care so everybody gets their diagnosis based on logic and the presentation of symptoms versus irrelevant diagnostic tests.

The first and most glaring error made in the diagnosis that led to the surgery was the idea that the connective sheath is the cause of the loss of range of motion and pain/difficulty extending the finger. Remember, the person can’t move the finger pass the locked position on it’s own or it hurts and snaps when they can. But they can take the other hand and move it past the point to the extended position without difficulty or pain. What that says is that there is nothing wrong with the connective sheath that the tendon passes through. If that were the cause of the limited motion then it wouldn’t matter how the finger was attempted to be put through motion, it would be stuck at a specific point. That is the key when identifying structures as the cause of pain or limited motion. The motion must be limited both actively (the person tries to move the affected joint through motion) and passively (the person moves the joint with the unaffected limb) equally at the same point in the range of motion. It is something that is so obviously in logic that it astounds me is not noted or included in the diagnostic process with the existing medical model and specialists making these types of diagnoses.

Trigger finger is simply shortening of the flexor tendons to the fingers that get so short that when the fingers are flexed, the tips of the fingers are closer to the elbow where the muscle/tendons begin that it becomes harder for the tendon to lengthen enough to let the fingers fully extend. It is a muscular cause, it is not a structural cause. But as I point out in all areas of the body, muscular causes are not identified by diagnostic tests nor are they understood by specialists with very limited and isolated educations and backgrounds. I just find it very painful to know that people will go through surgeries for no reason other than the ignorance of the existing model.

I hope you can see that in this example, the obvious physical presentation of the symptoms clearly indicate that the cause of trigger finger is actually coming from near the finger flexor attachment near the elbow and not at the joint where the limitation in range of motion of the finger exists. This is a representation of how every diagnosis is provided in the body why if you allow the existing model to be the method you use to diagnose the cause of your pain, unnecessary surgery is a real possibility. The system will not change. You will have to change the system.

Share this story

Share on facebook
Facebook

DR. MITCHELL YASS is the creator of the Yass Method for diagnosing and treating chronic pain. He developed his method over 20 years treating thousands of patients resolving their pain and returning them to full functional capacity. He has stopped thousands from getting unnecessary surgeries and resolved the pain of thousands of others who had surgery that did nothing to alter their pain.