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.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The RheumatoidArthritis.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

View Comments (13)
  • Barbara Vincent
    2 years ago

    Oh yes, unfortunately I have. I felt fine and it was a lovely day, so I decided to trim back the Monstera Deliciosa plant at the door, which had turned into a huge plant almost blocking the stairs. So did that and felt fine. Sat down and had a coffee. I thought o.k., I’ll just do a little more work in the garden before I put the tools away. Then, unfortunately, I stood up. A tremendous pain in the pelvis hit me and I could hardly move. I thought oh, looks like I have overdone it, better have a bit of a rest. All day and then all night the pain worsened, by next morning about 3.30 am I knew that I was in trouble. By 6.30 am I knew that if I didn’t call the ambulance I wouldn’t be able to make it to the phone. The ambulance people, who were just lovely to me, arrived soon after and took me to hospital where I was admitted. No amount of morphine helped. for the next 5 days I was unable to walk or even sit up. An RA flare was diagnosed as I had a CCP of 270+ and another reading for ANA was over 750. Apparently RA can also attack the joints in pelvis, which I hadn’t known before. So now, I am very careful to note the first signs of a flare and begin my special plan to prevent it. I never want to experience another 8 days in hospital like that again if I can help it.

  • Tigercin
    2 years ago

    This past Tuesday I was in the ERain for horrendous knee pain. I thougot I had somehow injured it. I called my PCP first, they suggested I call an orthopedic specialist, no one could get me in go at least a week. They all suggested I go to the ER. So I went, had an x-ray, two ultrasounds, blood work done, etc. Everything came back pretty normal except for the ultrasound of my knee showed signs of the arthritis. So the Dr called my rheumatologist and they diagnosed it as a severe flare up of my RA. So I am now at the tailed of taking methoprednisolone. And also some stronger pain medication as it istands still pretty painful, especially at night. I had my reminder infusion yesterday and see my rheumatologist in two weeks as that’s the soonest they can get me in with him. So, hopefully, the steroid will help and I won’t need another ER visit before then.

  • Kelly Dabel moderator
    2 years ago

    So sorry to hear about your knee pain Tigercin. Wishing you some relief soon. In addition to speaking with your doctor, this article on Knee Pain may be helpful to you if you haven’t seen it already: https://rheumatoidarthritis.net/symptoms/knee-inflammation-swelling-and-stiffness/. Let us know you’re doing. Best of luck at your appointment in a couple weeks. Kelly, Rheumatoidarthritis.net Team Member

  • LibbyRa
    2 years ago

    I’ve had terrible pain in my thumb and fingers before….somewhat like you describe. I was told it was “trigger finger”, where the tendon gets “caught” in the sheath. I’ve used heat before to help it feel better or just massaged it too.

  • Lisa Emrich author
    2 years ago

    Hi LibbyRa,
    I wondered about “trigger finger” as well. I have that in a pinky when I’ve been typing for too long, but this was different. I’m glad that heat worked for you; that can often be very soothing. Thank you for sharing.
    Best,
    Lisa

  • Richard Faust moderator
    2 years ago

    Thanks for sharing LibbyRa. Hope this finger pain issue is doing better and not recurring too often. Thought you (and others) might be interested in this article from one of our contributors examining the fact that RA can and does attack the connective tissues – cartilage, tendons, ligaments: https://rheumatoidarthritis.net/living/attack-on-connective-tissues/. Some times these areas get overlooked in the focus on the skeletal system. Wishing you the best. Richard (RheumatoidArthritis.net Team)

  • Lawrence 'rick' Phillips
    2 years ago

    I was typing and I had a terrible pain in my hand. Turns out it was a hurt extensor tendon. It is not clear exactly what happened, but the hand specialist was sure of the injury. Time healed it, but yes it was difficult going. I hope your injury is already getting better.

  • Lisa Emrich author
    2 years ago

    Hi Lawrence,
    So strange that something so innocent, such as typing or turning on a light switch, can result in huge pain. I’m sorry that your tendon was injured. But I’m really glad that it healed. My hand is already much better and I haven’t felt any hints of the problem since a few days after this event.
    Best,
    Lisa

  • Eebtool
    2 years ago

    Hi Lisa –
    Just a few weeks back, I had spent a hours hours down in the workshop finishing up a few projects, turning some screws, doing some painting and by bedtime that day the tendon (that is what I call it) for the right hand ring finger, on the palm side just ached and the attached finger pretty much was just along for the ride where the hand went.
    It was almost like I had smacked it with the hammer. But when morning came, it was just tender and a little stiff. You would think that my whole hand would be hurt, not just one part in the palm of my hand.

    I have also had a thumb, just lock up holding a glass. I grabbed it and forced it back into place. I told the doctor at my scheduled appointment a few weeks later, he said it could have just gotten hung up on a node.

    It is so strange, that just doing a simple task can can change your day?

  • Richard Faust moderator
    2 years ago

    Thanks for sharing your story Eebtool. You bring up a very important point when you mentioned bringing up this hand issue with your doctor. Every new symptom/issue should be brought up with your doctor, even if it has since disappeared. This article from one of our contributors looks at when a patient and doctor disagree on the level of disease activity/severity and how good communications can help get the two on the same page: https://rheumatoidarthritis.net/living/doctor-agree-severity-ra/. Thanks for being part of the community. Best, Richard (RheumatoidArthritis.net Team)

  • Lisa Emrich author
    2 years ago

    Hi Eebtool,
    Thank you for sharing. This is a strange one. I’m glad that your finger went back to normal as did mine.
    Lisa

  • Carla Kienast
    2 years ago

    Hi Lisa: I had something similar happen to me! It was completely weird. I was fine, then all of a sudden, just sitting and watching TV one evening, the middle finger of my right hand was suddenly zapped with pain and, like you, I couldn’t straighten it and it started to swell. Nothing else was affected. It lasted for 36 or 48 hours then was completely fine. Until one of my toes swelled up. I put it down to a sudden, bizarre, RA attack because I had no other explanation. Haven’t had anything like it happen since. (See my blog here: https://carlascorner.wordpress.com/2011/11/04/this-is-weird/) Hope things are back to normal for you!

  • Lisa Emrich author
    2 years ago

    Hi Carla,
    Thanks so much for sharing with me! I feel relieved that this isn’t entirely unique. Things returned to normal, although tender, by the next morning. I was just so shocked and somewhat scared. I definitely didn’t want anything to come apart or burst. I remember the excruciating pain I experienced before diagnosis and I don’t want anything like that to happen again.
    -Lisa

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