Could my medication be causing my swollen ankle, pain in fingers and heel?

Q I am a 58-year-old man, of a height of 1.72m and a weight of 74kg.

I have a slightly swollen left ankle and pain in my right heel. Over the last one year, I have developed trigger fingers.

I know this condition is quite common in my age group but it is affecting one finger after another.

At present, seven of my fingers are affected. It is painful. I cannot grip and type without any pain. I have already had three injections. My doctor now suggests surgery.

Please explain what causes trigger fingers.

I suffer from insomnia and have been taking zopiclone every night for the last 10 years. I cannot sleep if I do not take it. I have also been taking sertraline for about four months. Now I sleep about four to five hours every night.

I have been taking simvastatin for two years and my cholesterol is under control. Occasionally, I need to take senna to help my bowel movements. Does taking all these types of medication cause trigger fingers?

I used to drink three to five bottles of beer a week and a third of a bottle of whisky every three months, but I have stopped for three months now. My uric acid level is normal and I do not have diabetes.

A In traditional Chinese medicine, a trigger finger is probably caused by a deficiency of the liver and kidneys.

Good circulation of adequate qi (energy) and blood is required for good health.

The liver and kidneys control the tendons (bands of fibrous tissue that connect muscles to bones) and bones respectively.

Malfunction of the liver and kidneys - due to ageing, chronic diseases, weak constitution, tiredness, insufficient qi and blood and/or blood loss - will weaken the tendons and bones.

This will trigger intermittent pain in the fingers and, as a result, they lose strength and are unable to grip objects. Other symptoms include soreness and numbness of the limbs and/or lower back and knees, water retention in the legs and ankles, heel pain, insomnia and dizziness.

The tendons, fascia (connective tissue) and ligaments (bands of fibrous tissue, each connecting a bone to another bone) of the body rely on the nourishment of blood.

When qi and blood are insufficient - due to ageing, chronic diseases, weak constitution or insufficient sleep - to nourish the tendons, external pathogenic (disease-causing) factors such as "coldness" and "dampness" can invade the fingers.

"Coldness" will trigger severe pain of the fingers but it can be relieved by warmth. Further aggravation by coldness can worsen the pain at night.

"Dampness" will trigger swollen and sore painful trigger fingers and restrict finger movement.

Injury or overuse of the fingers with frequent repeated gripping can cause the blockage of qi and blood and create blood stasis in the affected fingers, accompanied by swollen joints, stiffness and difficulty in movement.

Herbal Options

HERBAL OPTIONS

Chinese herbal medicine (both taken orally and applied externally), acupuncture, moxibustion and cupping therapy can help improve your condition by strengthening your organs and dispelling the pathogenic factors.

Moxibustion involves burning a small herb above acupuncture points to help healing. Cupping involves using fire and cups to create a vacuum on the skin to enhance blood and qi circulation.

Chinese herbs such as Chinese taxillus herb, eucommia bark, cassia bark, barbary wolfberry fruit, medicinal cyathula root, morinda root, fleeceflower root and Himalayan teasel root are used to strengthen the liver and kidneys.

Common club moss, argy wormwood leaf, cassia twig, prickly ash peel, Manchurian wildginger, common monkshood mother root and kusnezoff monkshood root dispel "coldness" and "dampness".

Sappan wood, suberect spatholobus stem, safflower, peach seed, common burreed tuber, red peony root and red sage root enhance blood circulation.

You should avoid activities that require repetitive gripping or the prolonged use of affected fingers.

Keep your fingers warm and dry.

Avoid drinking cold water, washing your hands with cold water, or having a fan or air-conditioner blowing directly at your body.

Stretch your affected fingers gently and massage them lightly to enhance qi and blood circulation to reduce pain in your fingers and to maintain their mobility.

Soaking your fingers in warm water with rice wine and ginger also helps reduce the pain, swelling and severity of the triggering sensation.

Lim Lay Beng, traditional Chinese medicine practitioner at YS Healthcare TCM Clinic at The Adelphi.

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