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Treatment options for bone spur in finger joint

691 Views | 5 Replies | Last: 4 mo ago by bigtruckguy3500
Absolute
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AG
Background

About 4 years ago I started having pain in the middle finger of my dominant hand. Presented mostly in the middle joint and is worst when the tip is pressed sideways. Figured it was a sprain (have had lots over the years) so I buddy taped it and went on. Pain would come and go but never really went away. Moved on to various braces. No luck.

In 2023 I had met my deductible from shoulder surgery, so went to a hand specialist. He identified a bone spur on the xray in the first joint (closest to the palm) of that finger and said he thought that was the cause. Gave me a cortisone shot in that joint. That worked. Pain went away completely for about 9 months.

Went back for another shot and to find out how things might be resolved more permanently, like removing the bone spur. He did the shot and said the permeant fix was joint replacement. I was a a bit taken aback. He is a bit gung-ho and cocky, but didn't really press that it needed to be done soon.

When that shot wore off, I went to a different hand doctor to get a second opinion. He agreed about the bone spur and that joint replacement was the only surgical solution. Then he added that he would not recommend the joint replacement for me at my age (54) and activity level. That he would advise years of the shot because "joint replacement in the hand is not as far along or successful as some other places."

I never really got an answer as to why they cannot just remove the bone spur.

Wondering if our TA H&F gurus can clarify this for me and if anyone has had success with other options to treat or resolve this issue. Last shot is wearing off and it is really annoying. Hurts most of the time and ranges from 1 to 7 or 8 in pain level. So gonna go get another cortisone shot soon.
bigtruckguy3500
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Do you have an x-ray to post? I'm curious where exactly the spur is and if you have any associated degeneration. In general, you want to avoid joint replacement for as long as possible with conservative measures - your injections. Usually they can inject a joint up to every 3-4 months. I'm not very familiar with finger joint replacements. But I suspect the location or size of your spur, and potentially surrounding joint degeneration are factoring into their recommendations. If they don't think you'd get relief from shaving down the spur, they aren't going to recommend it.
Absolute
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I never got a copy. As I recall it was just barely visible. It was located roughly on the back side of the joint and toward the pinkie side. He was able to push really hard on it and make it hurt. He did not mention noticing any degeneration in the joint.

He also had me get a blood test for arthritis and it was negative.

Guess I'm still doing ok on duration on the injections if I am making it around 8 months.
Mr. Thunderclap McGirthy
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DON'T!!!!! Unless your hand specialist is the greatest in the world.

Too much can go wrong. I've seen lots of trauma. Hands scare me. "***** He'll never be able to feel from that finger again." An actual quote in surgery.
In Hoc Signo Vinces
Absolute
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Champion of Fireball said:

DON'T!!!!! Unless your hand specialist is the greatest in the world.

Too much can go wrong. I've seen lots of trauma. Hands scare me. "***** He'll never be able to feel from that finger again." An actual quote in surgery.


Yeah. That seems to be the way it is. Basically what the second guy said. Although the first guy claimed to be the best in the world.

I don't mind the shots.

Only conflict is that I had a case of CSC happen with my eyes this year. Alarming and very annoying. The retina specialist says the contributing factors are stress (CHECK). And cortosteroids. He actually blames Flonase the most. But he is not enthused about the joint shot idea.

Had a previous flare up of the csc 20 years ago. From his scans he can see there were non clinical occurrences over time.

Gonna hold off as long as I can on the shot then try it and let the retina doc look and see what it does.
bigtruckguy3500
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With CSC, I've seen it mostly in people that have high stress levels, and oddly enough in people that are super chill and have no risk factors. If the surgeon is doing the steroid injection and gets in the right spot, you should have minimal systemic absorption, but obviously if you're at risk for CSC, even a little might affect it.

Tough spot to be in.
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