An Ayurvedic Management of Trigger Finger (Stenosing Tenosynovitis) : A Case Study.

About Author

Correspondence Address

Dr. Sneha Waghmare (Naringe)
BAMS, MD, PhD Scholar
Assistant Professor ( Kayachikitsa)
JAMC, Nagpur
Contact no.- 8956076635
Email ID - snehapraful14@gmail.com


Contact No. : 8956076635, Email : snehapraful14@gmail.com

Date of Acceptance : 11 Jul 2023

Date of Publication : 10 Aug 2023

Article ID : SD-IJAY_026

How to cite this article : Waghmare S. Importance of Bhramari Pranayama in Nidranash (Insomnia)- A review article. Sanjivani Darshan National Journal of Ayurveda & Yoga 2023;1(1):1-4 http://doi.org/10.55552/SDNJAY.2023.1101

Abstract

Trigger finger is a condition that affects one or more of the hands tendons, which makes it difficult to bend the affected finger or thumb. Trigger finger occurs if there’s inflammation and swelling of tendon or sheath. It is commonly seen in women and  people above 40 years old, and those with certain medical conditions. A 46 year old female was brought in severe condition. She had very much difficulty in moving and bending her thumb of right hand. History revealed that she was suffering from trigger finger disease since 6 months. She had taken modern treatment which included steroids and NSAID drugs but got no significant relief and finally advised surgery for it¹. She was successfully treated with external and internal medication of Ayurveda. She got significant relief in pain and movement of thumb and her quality of life was markedly improved. This case study demonstrates that trigger finger condition can be well managed with Ayurvedic medicines.

Keywords : Trigger finger, Stenosing tenosynovitis, Mahanarayan oil, Mahavishgarbha oil, Guggultikta Kashaya

Introduction

The condition that affects one or more of the hands tendons, which makes it difficult to bend the affected finger or thumb is known as trigger finger disease. If there is inflammation and swelling of tendon then it can catch in the tunnel it runs through the tendon sheath. This condition makes difficult to move the affected finger or thumb and can result in clicking sensation. Trigger finger is also called as Stenosing Tenosynovitis or Stenosing Tenovaginosis. Thumb, ring finger or little finger is mostly affected in this disease².

CASE REPORT

A 46 Years old female was brought to hospital with difficulty in moving and bending her right-hand thumb. History revealed that she was suffering from this condition since 6 months. Other past history also revealed that she was suffering from D.M. since 10 years. No history of fall or trauma found. On examination, severe tenderness with thickening and swelling of tendon sheet of right thumb was found. Triggering of thumb was also present. Patient was unable to pick any object and has no grip to right hand due to limited and painful motion of right hand thumb. Motions of thumb like Abduction, Adduction, Extension, Flexion and Opposition was also hampered and limited due to severe pain. After doing Prakriti Assement it was found that patient was of Kapha Vataj Prakriti with Upastambhit Sthanik Vatavyadhi lakshan. As clinical examination gave the idea of diagnosis no related laboratory or radiological investigations done. Blood sugar was under control with modern medication. Considering the history, clinical examination, following treatment was given.

Table No. 1 TREATMENT PLAN

DO’S AND DON’TS

• Don’t give pressure on affected finger.
• Do regular physiotherapy of affected finger.

Table No. 2  OBSERVATION

Discussion

The patient was observed for 60 days with above Ayurvedic treatment, there was gradual decrease seen in inflammatory signs, triggering, grip of thumb and in motions of thumb. Here Ayurvedic treatment included Abhyang at right thumb with Sneha Dravya. In Siddhisthana while dealing with Snehan Karya, Charak has vividly explains its “Mrudu Karoti Deham” function^3,4.  Also one of the first daily health rituals as part of of Dinacharya (daily regimen), specified by the Brithattrayi, and Lagutrayi to maintain good health and wellbeing is Abhyanga- practice of self-massage. Abhyanga (oil massage) is a form of Ayurvedic medicine that involves massage of the body with specific warm herbs infused oils^5.  In external snehan Abhyanga has been considered as important part. In the Classics, Snehana is also known as Oleation. Literal meaning of snehan is love or tenderness. Charaka Acharya says that whatever causes unctuousness, fluidity, softness and moistness in the body is Snehana or oleation therapy⁶. We had applied the same function here. Besides that we had given Vatashaman Chikitsa with Guggul Kalp and Dashmoolarishta^7,8,9. The anti-inflammatory action of Guggul has been already proved¹⁰. Here Ayurvedic medicines were firstly given to relieve local Aam as a sign of inflammation with Tikshna and Apatarpan chikitsa for 15 days and then as Aam relieved considering the age of patient further Vaatshaman, Snigdh and Ushna chikitsa was given. Patient is now able to her day to day work with no difficulty.

Conclusion

References

1. Anderson B, Kaye S. Treatment of flexor tenosynovitis of the hand (‘trigger finger’) with corticosteroids. A prospective study of the response to local injection. Arch Intern Med. 1991;151:153–6. doi: 10.1001/archinte.151.1.153. [PubMed] [CrossRef] [Google Scholar]
2. https://www.nhs.uk/conditions/trigger-finger/
3.  Chakrapani,  Charaka,  Dridhabala. Siddhi  Sthana,  Chapter  1  verse  7.  In: Acharya  JT  (editor).  CharakaSamhita with  Ayurveda  Dipika  Commentary.  Reprint  2014  edition.  New Delhi:Chaukhambha  Publications. 2014;p.678
4. Ashtangahridaya of Vagbhatta, Sutra Sthana Sarvangasundara commentary of Arunadatta & Ayurvedarasayana commentary of Hemadri, Edited by Pt. Hari Sadashiva Shastri Paradakara Bhishagacharya; Chaukhamba Sanskrit Sansthan, Varanasi, Reprint, 2009; 243: 16-1.
5. Charaka Samhita of Agnivesh, Sutra Sthana Ayurvedadipika commentary by Chakrapanidatta, Edited by Vaidya Yadavaji Trikamji Acharya; Chaukhambha Surbharati Prakashan, Varanasi, 2013; 42: 5-85. 
6. Charaka Samhita of Agnivesh, Sutra Sthana Ayurvedadipika commentary by Chakrapanidatta, Edited by Vaidya Yadavaji Trikamji Acharya; Chaukhambha Surbharati Prakashan, Varanasi, 2013; 120(1): 22-11.
7. Jabbar S, Khan MT, Choudhuri MS, Sil BK. Bioactivity studies of the individual ingredients of the Dashamularishta. Pak J Pharm Sci. 2004;17:9–17. [PubMed] [Google Scholar]
8. Gogte VM. Ayurvedic Pharmacology and therapeutic uses of medicinal plants. In: Ramkrishnan S, editor. Dravyagunavidnyan. Mumbai: Bharatiya Vidya Bhavan; 2000. pp. 287–8. [Google Scholar]
9. Sharma PV. In: Dravyaguna – Vigyan. Vol. 2. Varanasi: Chaukhamba Prakashan; 2001. Tritiya Adhyay Hridyadi Varga; pp. 221–2. [Google Scholar]
10.  . Kimura I., Yoshikawa M., Kobayashi S., et al. New triterpenes, myrrhanol A and myrrhanone A, from guggul-gum resins, and their potent anti-inflammatory effect on adjuvant-induced air-pouch granuloma of mice. Bioorganic and Medicinal Chemistry Letters. 2001;11(8):985–989. doi: 10.1016/s0960-894x(01)00111-1. [PubMed] [CrossRef] [Google Scholar]

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Conflict of interest: Nil