The “snapping finger” is a disease of  the hand and finger bend tendons. As a result of a thickening of the tendon it will no more slide smoothly underneath a ring tendon, which provides its fixation. The constriction of the tendon leads to friction, which will intensify the tendonitis. Sudden spring-like movement during stretching of the finger can be the result. This phenomenon will appear at first especially after sleep or after an extended period of hand relaxation, later on during every movement of the finger. In advanced stages of the disease the finger may be fixated, so that it can no longer be stretched or bent.

All of the fingers can be affected, although thumb, ring finger and middle finger are most commonly concerned.

In some cases the typical “snapping finger” does not occur. However, severe pain is felt, when closing the hand to a fist or stretching of the fingers.

In early stages one commonly notices pain induced by pressure or motion located around the first ring tendon, i.e. in the palm right underneath the skin fold of the affected finger. As the disease progresses tendons can no longer slide smoothly, the “snapping finger” occurs later on. The snapping is felt in first joint of the finger, while its cause is the ring tendon in the palm. The snapping can happen without pain, which may change during the course of the disease.

In the early phase the disease can be treated with anti-inflammatory pills (NSAR).

Often a surgery is necessary, that can be done on an outpatient basis using local anaesthesia of the hand. The procedure usually takes only several minutes. A cut in skin of about 1cm length is used to access the ring tendon, which is then split to give the surrounded tendons the appropriate space. The finger will move without inhibition shortly after surgery.

After surgery the patient leaves the practice with a light bandage. After 2-3 days a simple plaster is sufficient. It is important to exercise the finger with movements starting the day after surgery to prevent the resulting scar from clogging the bend tendon. Initially burdensome tasks have to be avoided to prevent distinctive swelling. Fitness for work will be restored after 10-20 days (depending on your profession). Sometimes swellings and problems related to the scar persist until up to 6 weeks after surgery.

It describes an inflammation of the tendon sheaths of the thumb stretching tendons at the wrist. Overexertion is the cause for this disease. If chronification occurs scarring and as a result tightening of the tendon sheath lead to distinct pain, as the tendon can no longer slide smoothly.

Movement of the thumb results in heavy pain. Gripping objects tight is painful as well. The pain may radiate into the lower arm. A knotty thickening of the tendons at the wrist is common. In later stages the tendons can be totally blocked in their movement.

In the early phase conservative therapy may lead to success. Anti-inflammatory pills (NSAR), application of ointment and fixation with a plaster splint can alleviate the symptoms.

In chronic stage surgery is the only option, which is done on an outpatient basis using local anaesthesia and will only take several minutes. A 1,5-2 cm cut in the skin is made and then the stretch tendon section is split, so that the tendons can once again slide smoothly and without pain.

After surgery the patient leaves the practice with a light bandage. After 2-3 days a simple plaster is sufficient. It is important to exercise the thumb with movements starting the day after surgery to prevent the resulting scar from clogging the bend tendon. Initially burdensome tasks have to be avoided to prevent distinctive swelling. Fitness for work will be restored after 10-20 days (depending on your profession).

A tennis elbow, or “Epicondylitis” in professional terminology, describes a painful state of irritation of the muscle insertions at the thumb-sided bony protrusion of the elbow. Middle-aged men and women are mostly affected (35-55 years). Usually people who suffer from tennis elbow are not actually tennis players, but craftsmen, handymen, housewives, computer workers and others.

The cause is a regular overexertion of radius-sided lower arm muscles through one-sided exercise or malposition. The resulting tension of the musculature leads to overstress of the muscle insertion at the elbow. An inflammatory irritation emerges, which manifests itself during movement or under applied pressure.

At first one feels a painful tension of the lower arm muscles. Later on stinging and burning sensations can be felt at the elbow upon closing the hand to a fist, stretching the hand away from the lower arm or rotary motions, especially if these motions recur. As the disease progresses a loss of power can be noticed during certain activities.

In 90% of the cases the symptoms can be alleviated through conservative therapy. The first measure will be to avoid pain-inducing activities. Ointment application and anti-inflammatory pills (NSAR) relieve the acute pain and the inflammatory irritation. Injections of cortisone compounds can also be used to reduce the pain. Fixation with a plaster splint to treat the acute inflammation is a short-term procedure. Special tapes, so-called “Kinesiotapes” are often applied to support arm-movement. Wearing an orthosis and its measured pressure on muscle insertion has also a pain reducing effect. Physiotherapy and manual therapy stretch the tense muscles, exercises for self-therapy can be learned.

In 10% of the cases conservative therapy does not lead to success. In this case a surgery is indicated as the only remaining option. The muscle insertions will be notched, which results in a relief of muscle tension. By sclerosing the nerves atop of the bone in indicated areas the pain can be alleviated.

By using the “Wilhelm-method” our success rate is 90%, i.e. nine out of ten of our patients are permanently relieved from pain after surgery.

“Wilhelm-method” means that the surgery is done on an outpatient basis during anaesthesia. After surgery the concerning arm has to be fixated with an orthopedic splint for the period of wound healing, i.e. 10-14 days. Simultaneously exercises begin under professional physiotherapeutical instruction . Depending on your profession the estimated time until return to the workplace is possible is 4-6 weeks.