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Painful and Bent Finger

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My middle finger is bent slightly to the ring finger, on both hands. However, the middle finger on my right hand is curving a lot, as compared to the left, and is also showing a slight bump on the uppermost joint, which is painful; on the same finger, the middle joint is also swollen and painful.

It is my habit when writing to rest my pen on the middle finger, and this causes the uppermost joint to push out quite significantly. I'm currently a high school student, so I do a lot of essay writing and all that, and I think it may have an effect on the posture of the finger.

Also, a few months back, my hand was sprained when I fell down.

I don't know the cause of this, and I really want to reduce the pain and the curve of that middle finger, as it is my main writing hand and my exams are round the corner.

Thanks for the advice in advance. Smile
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replied June 24th, 2012
Especially eHealthy
saffronsardine,

The slight curvature of the middle finger ulnarly (towards the ring finger) is actually quite common. While it may be worsened by constant pressure from your writing posture, that is not the underlying cause, as you have it on both hands, and you do not write with your left hand. Again, the slight curvature, also called clinodactyly, is very common in the middle finger. Clinodactyly is most commonly seen in the small finger, and in that finger, can have several underlying causes. The slight bend in the middle finger, usually, it is not a problem.

But, since you are having difficulties, you may need to have it evaluated by a hand surgeon. You state that you "sprained" your hand a few months ago, but do not say if the middle finger was actually injured. "Sprained" or "jammed" fingers can actually take a long time to resolve. Fingers do not take injury well, and will stay swollen and painful for many months. In some cases of significant joint injury, the interphalangeal joints may stay enlarged permanently. The PIPJ (proximal interphalangeal joint), or sometimes called the middle knuckle, is notorious for staying enlarged after significant injury.

As to the curvature being made worse by writing, there are a few things that you can try. Mainly, it is just trying to change your writing posture and habits. First, try not to strangle your pen. If the skin of that finger blanches when you write, you are grasping your pen too tightly. Try to relax some. Also, try to write using your whole arm, not just the fingers. Back in the old days, when writing was taught in school, there were exercises that were done to emphasize not using just the fingers. To do these, sit upright, with your forearm resting on the table. Start by making continuous O's, using your shoulder (yes, the shoulder) and not moving your fingers. It will feel funny at first, but get used to using your whole upper extremity to write. Once the O's become fluid, try script writing without moving the fingers.

You should also get a pen that is very large in caliber. The very small instruments cause fatigue and discomfort in the hand. So, remember in kindergarten, you used very large crayons and pencils, well, that is the size of pens that you should be using. If you have a favorite pen that is small, and you want to continue to use it, you can get foam or rubber pads to go over the pen. You can get them at any office supply store.

There are also some neoprene sleeves you can get to go over the last joint of your finger. These help to prevent the formation of a callus on the side of the middle finger. They also help some with the discomfort. It is common for people who write a lot, to form a callus on the radial side of the DIPJ (distal interphalangeal joint), which makes the "deformity" of the finger appear more pronounced.

So, again, try to relax your grip, don't use just the fingers to write, use a large caliber instrument, and maybe try a sleeve over the finger.

Also, take a break whenever you can, to stretch the fingers and wrist joints. Shake out your hands and do range of motion (opening and closing the hand several times).

You might also try some over the counter medicine such as acetaminophen or NSAIDs (such as motrin or naprosyn), if you do not have any problems taking such medicine, when the hand is bothering you significantly.


But, again, if the above suggestions do not help significantly, you may need to see a hand surgeon for an evaluation.

Good luck.
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Users who thank Gaelic for this post: saffronsardine 

replied June 24th, 2012
Hi Gaelic,

Thanks for the comprehensive and helpful advice. I think I understand the problem better now. I'm going to get a rubber pad for my pens.

But just to make sure, I remembered someone telling me that a joint pain may be indicative of gout - how probable is that given that I'm only around 16?

Thanks again! Smile
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replied June 25th, 2012
Especially eHealthy
saffronsardine,

Gout is a crystalline arthropathy, due to abnormal uric acid metabolism. Uric acid crystals get deposited in the synovial lining and fluid of joints in patients with this problem. In patients with gout, they have to watch their diets, as consumption of foods high in purine (an amino acid) cause the gout to flare. Foods high in purine are ones that are rich, such as fatty meats, red wine, high fructose corn syrup. Thus, gout used to be a disorder of the high society (disease of kings or rich man's disease), the only ones who could afford these foods.

However, gout is quite rare in young persons. It is usually first seen in middle age men (a little older in women). The MTPJ of the great toe is the most common joint affected (why the disorder is often called podegra), but any joint is susceptible. A joint with gout will be very painful, red, swollen, and warm. Once you have seen a gouty joint, you usually can't miss it.


So, in a young person, gout would not be high on the list. It is possible, in youngsters who have a genetic defect in purine metabolism, but usually a patient will know they have the problem from a very young age, as it also affects other organs in the body.

It is much more common for young patients to have trauma to the joint, causing the discomfort or swelling. This can be one time acute injury or minor, repeated injuries (overuse).

Some young patients do have an inflammatory arthropathy (there are a huge number of these, such as rheumatoid arthritis, Reiter's syndrome, etc). But, these usually affect many joints in the body, not just one. So, again, when the problem in limited to one and a couple of joints, trauma or overuse is usually the cause.


Again, if the condition does not resolve, you may need to see a hand surgeon for a thorough evaluation. Do try some of the suggestions, they can make a big difference. Good luck.
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