I have developed a peripheral nerve problem as I move to retirement – it sort of doesn’t seem fair!
I was fishing during the Christmas break and I caught a wrasse or “rock cod” as we call them.
Wrasses can be beautifully coloured, but this one was rather dull, even ugly and we know they are inedible. As I was releasing the fish, a dorsal fin punctured my ring finger on the lateral side of the proximal interphalangeal joint. It bled profusely and really hurt at the time. Over the next few weeks it was clear that something had happened to the digital branch of the median nerve in my ring finger.
Such a tiny nerve but a real pain!
I have no trouble moving and stretching my hand but if I do it with the elbow extended and particularly with my shoulder elevated or shoulder girdle depressed, it really ‘zaps’. If I swim freestyle, dive into a pool, wave, pick up something off the floor, or weight bear on an extended wrist, it’s a real nervy twang in the innervation zone. I found myself using the word ‘jolts’ recently and I thought ‘that can’t be too good!’. If I palpate the spot where the fin entered, it really zings. I am starting to have a reluctance to do certain movements, though I wouldn’t call it a fear avoidance.
What’s going on in there ?
I am guessing that there is some perineural fibrosis at the fin insertion point – perhaps made more reactive via bacteria on the fin. I am thinking and hoping it can’t be an intraneural problem – nerves can usually slip and ‘get away’ from external forces, plus it didn’t react for two or so weeks.
I have been trying to gradually mobilise it – from repeated anecdotal experiences, I have reasoned that this has helped many people in the past. Initially this seemed to help but not lately and I am seeking a surgical opinion.
What have I learnt so far from my ‘wrasse finger”
- A quick and unforgettable review of the pathway and innervation zone of the digital branch of the median nerve to the ring finger
- It really feels like ‘neural tension’ despite me rejecting the term two decades ago.
- How quickly language can be generated to understand something, ie from a ‘zap’ to a ‘jolt’
- Respect for the usual toughness of nerves – we hit them, squish them on underlying bone, stretch and they usually come up OK.
- A reminder of how a minor problem in tiny nerve can alter function.
- Order of movement assessment strategies made no difference in this particular situation (ie similar symptoms and range were achieved despite the order of arm movement).
- Wear gloves next time
I’ll let you know how I go