A Sudden Trip to the ER; Is RA to Blame?

Yesterday evening, something bizarre and very painful happened to my finger. As I turned the kitchen light on, I had a sharp, sheering, level 8 pain in my middle finger. It was like lightening struck. I wasn't sure what I did.

My hand looked normal, but darn it if that didn’t hurt like heck.

With my fingers in a neutral position, things seemed to be okay so I continued downstairs to deal with laundry. However each time I tried to straighten my fingers, the pain shot through specific areas on the bottom and top of my middle finger. This pain prevented me from being able to fully extend my finger without wanting to let loose of some choice swear words.

I was afraid to try too hard to open my hand; I didn't want to push it. I wondered if I was about to tear a tendon and if this was the warning signal to stop doing what I was doing. I let my hand rest a little while. Tried again to straighten the finger. OUCH!!! Actually, the pain seemed worse and I thought that the underside of my finger had begun to swell.

What the heck did I do?

I wasn’t sure what was going on, but I became concerned that something had ruptured, or was torn, or caught in an unnatural position. Being afraid of causing serious and permanent damage, I finally decided that the ER was probably the best place to be evaluated quickly on a Friday evening. If something really bad was about to happen to my hand, perhaps it could be avoided or minimized with appropriate medical attention.

As a pianist, I need my fingers to be fully functioning. As a person with RA, I am afraid of permanent damage that will prevent me from being able to continue doing what I need to do, that is to play piano and type. Because of severe swelling before my RA diagnosis, I have crooked fingers on my left hand. Swelling had damaged tendons and caused boutonniere deformity in my left hand middle finger. Occupational therapy at the time and careful splinting helped me to reduce the amount of permanent damage and maintain function.

So last night, Rob took me to the ER and stayed with me for moral support. When asked what had happened, I felt totally silly explaining that I suffered no obvious trauma, but felt sudden pain when I turned on the kitchen light. A physician’s assistant examined me and ordered x-rays. By the time, I was taken for x-rays, my finger was feeling a bit better. I suspect that the examination and mild manipulation of my finger and hand allowed something to slip back into the space where it was supposed to be.

Following the results of the x-rays, an ER doctor came over to examine me. The x-rays showed nothing abnormal. The doctor asked me more questions about my finger and I had to admit that finally the pain had become much reduced. I didn’t have problems moving the finger and the tendons were functioning.

Could this be related to RA?

I asked if this could be related to RA and his response was a vague and noncommittal. But his “official” diagnosis was that I “tweaked” my finger. The area below my middle finger and in my palm was tender to the touch; still is. It could be that inflammation caused a sudden, but brief, problem in this area.

I felt sheepish leaving the ER with not much more information than I had arrived, other than nothing was ruptured, torn, or about to tear. The flexor tendons on the bottom of my finger and palm seem to be gliding just fine now. Tender, but okay. Whatever happened, I really hope that it doesn’t happen again. It was much too painful and I’m not ready to face the return of RA pain in the near future.

If you’ve experienced anything similar, I’d love to hear your story. Please share in the comments.

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