I have RA and like most of you have good days/ weeks and bad ones.
Sometimes when my hands are bad I can see and feel the tendons (not even sure if that's what they are callled!) slipping off my knuckles when I make a fist or grip things. Oddly my left hand is affected not my right (I'm right handed) and it is usually my middle finger and my ring finger which are affected.
When the tendons slip it hurts (a different sort of pain to the pain in my joints), my grip is weaker and it makes me feel sort of queasy. I mentioned this at my first appointment with my consultant to the nurse as I was on my way out of the department (When I always remember any relevant information!) and she passed the information on to the consultant and said it doesn't change the diagnosis of RA.
Today even gripping a fork hard enough to have control over it was causing the slip and the pain - uncomfortable enough for me to change to eat only with my right hand.
Does anyone else have this additional problem?
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Nikk
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30 Replies
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It sounds like you're describing what happens when you get a swan neck deformity. I have this on the ring finger on my right hand and wear an oval 8 ring splint to prevent the joint from over extending. I didn't think it was doing any good at first so stopped wearing it but the finger began to ache more and the dip on the end became more pronounced. I wear it all the time now except when I'm going on a night out...which sadly isn't very often. I think you should ask to see an OT to discuss splinting. You're rheumy nurse can arrange this for you. You're right in that it won't change the diagnosis but it should help you be more comfortable. Good luck
Hiya AnonYmouse666. If you check under Pinned Posts (to the right of your screen) you'll see entitled Common abbreviations and acronyms on this community. They should all be there if you should find yourself a little lost being new.
Thank you so much for the reply. Just looked up the swan neck you described and I'm not sure it's that - unless this is how it starts?!
It's the knuckle nearest my hand and the tendon slips over it - not sure if you're allowed to put links on here but I was able to find a clip of someone else's hand doing the same thing.
I have the same tendon slip on the knuckle of my left index finger. I too was told that it is because that finger is starting to develop a swan neck deformity. I believe it is something about overextension of the tendons which makes it slip that way. I have been wearing a finger splint on that finger for the last few months to stop the progress of the deformity. Do your fingers ever lock in the extended position and require extra effort to be bent? That was another feature that showed up with the tendon slipping.
Yes Nikk I get this type of tendonitis - this is how my hands were when my RA was diagnosed. Both my consultant and my physio told me it is and was one of the main criteria used to diagnose my RA. You can get RA in soft tissue and tendons just as much as in joints. In my case my tendon does exactly what you describe (slips over the knuckle nearest to my hand) and my physio gave me exercises to do to stop this happening.
My knuckle under my right finger is always a little tight and swollen now - especially in the mornings but my grip and ability to write and work with my hands is pretty much back to normal now. If you try bending your fingers above the affected knuckles so they are at 45 degree angle to your hand, keeping finger pointing straight and then bend them in towards your palm it sort of hooks over the tendon and prevents it constricting and allows your fingers to bend more easily.
For about a year I found it really hard to find wrist splints that avoided my painful and swollen knuckles but my OT customised some for me and I use them when my wrists are bad - which isn't very often now that the drugs are doing their work. I remember asking my rheumy consultant after he had diagnosed me and put me on MTX - whether I'd ever be able to grip or write or bend my affected fingers fully again and he said yes he thought I would and for the most part he was right. Hope this helps? - Tilda
Thanks for this - weirdly since the first visit to the consultant (back in Feb this year) the tendons haven't done it (or I haven't noticed them) so I haven't mentioned it to my OT. I'll give them a ring tomorrow!
I seem to be very much up and down at the moment. Last week the RA reared it's ugly head again and this week the knuckle weirdness has also come back.at my last visit I told the consultant that I felt back up to 95% of my pre RA self and now back to feeling sore, tired, the works- I don't need to explain here as you all know only too well what I mean!
Physiotherapy was really useful for me - she gave me several ultrasound massages a week on my tendons both when my knuckle was affected and then later when my ankle had the same problem. If you can access one it might well be very helpful for you too.
I haven't seen a physio yet but will give the rheumatoid helpline a ring tomorrow - you'll know what I mean when I say it feels like I shouldn't bend the fingers at all to avoid it happening but I'm pretty sure that wont help with long term mobility.
Well my physio said that if I carried on avoiding bending my fingers then pretty soon the joints wouldn't bend anymore and damage/ fusion of joints would be irreparable so she said to push myself as far as I could without actually forcing them. She said that the tight tendon (tendonitis) across my knuckle was having the effect of making the middle joint on the finger above it, which was very swollen and hot, seize up, so it was crucial to exercise it regularly.
I admit I found this very confusing at first because I was being told by OT and my GP to avoid repetitive movements or unnecessary over use of my hands. But what I learned was that exercise and over use of an affected tendon or joint are actually completely different things. The exercises I was given to do plus the frequent course of ultrasound massages have meant that I now have pretty good range of motion and grip with both hands. I still can't fully clench either hand, especially when I wake in the mornings when they are always stiff and a bit swollen, but hey that's not the end of the world unless I find I need to punch someone!
I love that last line - maybe I should punch all the people I would like to whilst I am still able...!
I'll definitely try to get hold of a physio asap - I know we can self refer at my GP practice so if they can't help when I ring the rheumatology helpline I'll go down that route.
My consultant is very keen on me keeping as active as possible- and it's something I see as important too so I
can see what you mean about the difference between exercise and overuse.
When I force myself to go for a walk even though it hurts I feel much better both physically and mentally when I get back but I'm learning my limits and do less on a bad day than on a good one.
I often think being as stubborn as a mule is pretty useful in these situations!
Yes being stubborn is the way forward with RA I feel. When I was still awaiting diagnosis my GP tut tutted about my red and inflamed knuckles and said "it would be much better if you didn't have the periods of intensive repetitive activity" (I had an exhibition coming up) and I explained that until I was told what was wrong and what I must or must not do I couldn't pay too much heed to painful joints so was just ignoring it. He screwed up his face but I am more mobile now than many and I have never found that keeping moving has damaged or debilitated me further - whereas the other way round joints stiffen and seize up on me if I don't move them or exercise frequently. With hands it best to get specialist advice though as the joints are so small and easily damaged. Good luck!
Hi TildaT. Can you please tell me the exercises that your physio gave you to stop your tendon from slipping off your knuckle? I have asked my rheumy and pt about what exercises can help this and they just tell me no exercises will help, that the tendon is stretched. Do you know if your tendon was stretched or tight? Either way, I would like to know the exercises you did .
I have gotten one round of prolo therapy to try to help with this. Can take four treatments to see a difference. Didn't notice difference with the first treatment.
The doctors say that the tendon would slip because it is loose, but I have tendonitis (tight tendons) throughout my hand. Can a tendon that is too tight also cause a slip of the tendon off the knuckle? Thanks.
Ask for a referral to an occupational therapist about your hands - they can really be a huge help in both showing you how to use your hands so they don't hurt so much, and also giving you aids that make life easier - even things like cutlery and pens with much easier hand grips.
Thanks for the advice. I'll try to get hold of the OT for a chat tomorrow - she was brilliant last time I saw her, really helpful and lovely. And it could be worse I suppose- could be my right hand too!
hi, i sometimes suffer with this problem, when it slips it can be a "sicky" feeling for a moment or two, then it throbs. my consultant reckons that it could be due to nodules forming on the joints, so when you go to grab something your tendon seems to "slips" off your joint. it happens more often at this time of the year, due to the cold weather and our joints swelling. i hope this helps you, dee x
This describes exactly how it feels - and the pain is definitely more of a throb than the other numerous bits of me that hurt due to RA. I put an oedema glove on and it helped a bit- would probably help even more if it fit me properly!
It makes me feel that I want to keep all my fingers straight and not move them but that's probably not the best thing for staying as mobile as possible!
It certainly helps to know that it isn't just me having these odd things happen to me.
Hi Nikk, I had this happen on my left hand over the middle & index fingers. It was swollen for years, and then when it finally went down, my Dr said that the tendon had stretched so it 'slid' over those joints. When I had the fake knuckles put in, they didn't shorten the tendon, so my new joints have gone off on their own towards my thumb. At least they don't hurt, mostly.
Thanks for your reply. I can see how the tendon would stretch over time with a swollen joint. I don't have any visible swelling with any of my joints but the rheumatologist has said that it is there, just not visible so mine may well be a similar thing.
I rang the rheumatology helpline number I have been given but due to annual leave there is no one to speak to for a couple of weeks. The answer machine message suggested ringing GP (I'll just be told to let the consultant know next time I see them) or go to A+E (No thank you!) so I'll just keep moving and carry on as normal until I see the consultant next or get an answer with the helpline!
So is my doctor stupid because I went to him today and said my tendon is slipping so he put a splint on my finger for a week. He isn't referring me to any other doctor, he isn't sending me to physio or anything. I spent a while asking around and stuff and they all told me they had an op or physio...
Hello, I'm 13 and haven't gotten this checked out but I have the same thing as you but it does not ache and I can grab things just as well as my right hand. It does not make myself queasy but it does weird my friends out. Should I be worried?
It's unusual for it to happen at your age. Have you previously injured your hand or are you hypermobile?
I am 29 and a few years ago I noticed the tendons slipping on the middle and ring fingers of my right hand at the knuckles. I have hypermobility syndrome, which means my connective tissue isn't as strong as normal. I used to work as a graphic designer and came to the conclusion that using a mouse for long periods of time caused the fingers to drift and the tendons to slip. I had an operation on my hand 2 weeks ago to stabilise my tendons because the hand became painful (didn't originally hurt).
My advice is to get checked by your doctor as soon as possible as they may be able to prevent further problems. Being referred to see a hand therapist may help. Perhaps you are hypermobile too, which would explain it and is something to talk to the doctor about too if you think you are.
The tendons are now slipping on my other hand so it's definitely something to tackle as early as possible.
Hi, i noticed this problem as well around a similar age to you. i am now 17 and only just looking up what it is, should i see a doc ASAP, my joints are all quite week and faulty but my GP just dismissed them as if they were nothing should i go for a check up? i can also do it in my Big toe tendon - not sure if this is related but seems to be a similarthing
I have the exact same thing, my index finger on my left hand (right handed myself)
the tendon that stretches over the knuckle and down the shaft of the top has visibly come out of place, i can see it when i clench a fist, (small bump just under knuckle on right side) it slightly hurts, like a ache, bruised kinda pain, very tender aswell.
I've also got the start of a ganglion cyst on my left ulnar to wrist and i have carpal tunnel on my left wrist.
This all started when i was doing weights, only 30kg, my left hand to fore arm have been having problem after problem but only with tendons.
I'm going Doc's tomorrow to fix it, checked online and it's hassle i really don't want
I have this problem too. I am right handed, and the tendons on my middle finger are slipping off. I find it uncomfortable but amazing. I still dont know how though, but I suggest you get a doctor to check it, and if the problem consists, you may need surgery. I will you luck on your journey to fix this. I'm not gonna care.
I snapped my finger. The fun way that you snap your finger to make a noise. When I did, the tendon ruptured that stabilizes the main tendon that runs down my hand to my middle finger. It now slips over the knuckle. The occupational therapist made me an inadequate splint. I can tell that even with the splint , the tendon keeps moving to the right. They said that by wearing this, it should heal itself and reattach. However I can tell that as long as the tendon is slipping, it will not reattach itself. I modified the splint to keep the tendon from sliding over. . I have to wait 6 weeks to see if it heals. I'm doubtful, but time will tell. It seems to me that the tendon should be reconnected to bond.
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