Right, 6 weeks ago I had a big otb. My thumb hurt but I had full movement so wasnt too concerned. A little swelling and bruising along the top of the thumb and palm appeared a couple of days later. I didn’t want to bother the NHS and a and e with what i thought wasn’t an emergency, so applied ice and ibuprofen gel.

4 weeks later, the thumb still felt stiff, some swelling remained and it didnt hurt to the touch but I had some pain in the mcp joint under certain movements. So, I went to the NHS walkin centre. I was told that my thumb looked deformed !?!, but they couldn’t help me, minor injuries and a and e won’t help me as its been more than 2 weeks since the injury and i need to get an x Ray appointment through my gp. The next gp appointment is on the 25th April.

So , I’m at a loss what to do. I feel that the good will of not going to a and e has hugely backfired and I’m now on a long road to just getting a diagnosis. Should I even bother. There has been no improvement since 2 weeks ago, I have a dull ache, some swelling and it’s painful to ride. Did I fracture it, damaged the ligaments ? I don’t know, but I’m conscious that my summer plans are at risk at this rate.

Is it worth.doing anything after 6 weeks or is whatever injury it was likely to be almost healed?

Wierdy I’m in the same boat. Got kicked in the thumb at karate during Christmas week. Hurt like a bastard but didn’t go to a&e because it was full of people dying of things.

Three months later and it still hurts.

Same issue here, although it’s the heel of my hand opposite my thumb.

Don’t vote Tory?

Sounds like skiiers thumb. Unfortunately it was a wait it out type of injury for me (I also had a tiny bone chip), could ride after a couple of months or so, but took a whole year to be completely pain free.

Effing tories.

My OH sat for 5 hrs in A&E with my daughter on saturday. She had been smacked in the head by a bully at school (with a door) the day before and we wernt sure if she had a dent in her eye socket. It wasnt causing her pain but you cant be too careful?

Called 111 and of course they sent her to A&E. they even said “stay at home, and we will call you when we need you, and you wont have to go through triage as weve done it over the phone”, which seemed like a great solution.

Anyway, Devon Doctors (basically, a GP availible outside the working week) has been cut, so a youngun who needs a quick poke from someone who knows what they are looking at gets in the queue in A&E with all the cylists with broken collar bones and car crashes.

OBVIOUSLY she gets queue jumped by the serious injuries, and we are totally fine with that, but they gave up after 5 hrs, when they were told it would be at least another 6 hrs.

It seems obvious to me that there should be a GP or a doctor whos job is to see the “5 minute poke” jobs, and get them off home again asap, just to keep the decks clear for the real problems!

In my view, they are being starved to make them look shit to facilitate moving to an american insurance model.

Weve never had anything but great interactions with RD&E, but whoever is starving their budget needs their head on a spike.

See Paul Whitehouses program about rivers and the privatisation of the water companies for further reference material.

Couldn’t you get a ‘new’ thumb injury less than 2 weeks old?

The uncomfortable truth is that most hospitals are sodded right now. I had cause to be in one last week and it’s just horrendous.

I sympathise, I sincerely do, but you’re going to be at the back of a very long queue of more critical patients. The best thing I can suggest is to jump on the NHS website, over here at least it lists all the local hospitals along with live waiting times and there is a stark difference between them.

After six weeks, you would expect the ‘healing’ process to be well-advanced. So there is, I expect, not a lot that could be done in terms of misalignment that would fall under the ‘urgent’ category. So it is probably a case of seeing your GP and waiting for a referral.

It’s possible you still have some residual swelling, and that it will subside further if you treat it nicely.

I recently made the dumb mistake of sparing the NHS by not attending with a nasty cut on my shin – result was an infection a week later, no option to stitch or steri-strip at that point…probably an extra couple of weeks off the bike.

Is there a minor injuries clinic you can go to? Many can do x-rays and refer you to hospital if needed.

The minor injuries clinic wouldn’t see me as the injury was over 2 weeks old.

I think thumbs and fingers are difficult to manage and little can be done other than splinting. What does your deformity look like? pics?

I had an otb in the summer, and got hands xrayed, and got referred to a hand specialist as they were concerned I had ruptured ligaments in the base of both thumbs. Fully mobility and ability to grip meant that doc was comfortable that no ligaments damaged and just sore.

Challenge is that some pre-existing arthritis has been exacerbated and am getting pain and swelling due to that.
My physio has recommended some strengthening and mobility exercises using elastic bands as mini-resistance bands and waggling thumb outwards and upwards.
Subsequent visit to thumb doc last week suggested taping the lower part of my thumbs to give support when riding the bike

The ‘deformity’ is some swelling on the top of the mcp joint. Nothing else as far as I can see.

scaphoid fracture? Done mine more than once falling. (Once kiting and once biking). Poor blood supply means a long time to heal.

If in pain I would honestly lie a bit. Say you fell a while back and it was fine but you have fallen again (your clumsy, not abused) and its really sore. Cue a 6hr wait (currently local time) but you will get and xray and confirmation of what you have done. Maybe playing the system a little bit but its no fun being in pain.

I’ve been in and out of hospital for the last three months with lymphoma. The actual specialst wards are awesome, but A&E is screwed because that’s not a hospital problem, it’s the sharp end of a social care system that’s fallen apart.
Instead of the expected random demographic of people that have had an actual accident it’s full of the people that have fallen through the net of either having no GP access, zero hours contracts and no capacity to go the Drs, cottage hospitals and minor injuries units all close.
Yeah, it’s all saved a few quid, but it’s totally screwed emergency care.
A few years ago there was outrage that max. wait times of 4hrs were being regularly breached, now 4hrs isn’t even considered a wait.
But sure, it’s those lazy NHS staff and nothing to do with massive underfunding, understaffing and Brexit.
gggggrrrrrrr

Could be a scaphoid fracture as db suggests. I cracked mine a couple of years ago. Did the same as OP hoping it was just a sprain. It didn’t get better. Long story but eventually got it x rayed 4 months later. Then operated on. A nice wee self tapper inserted in to pull the bone together. Scaphoid then quickly knitted itself together. Well 4 weeks later it was healed. I kept the self tapper.

Suggest as above go to a different minor injuries or a different shift in the one you visited. White lie I did this two days ago or yesterday. Get an x ray then you will know.

I had considered if its a scaphoid fracture but I have no pain in the vicinity of the scaphoid/wrist, even when prodded and squeezed and had no swelling in that area. Can a scaphoid fracture result in.thumb pain?

A white lie had crossed my mind.

So your choice seems to be sit it out to 25 April for that X-ray, or try and game the system for a multihour wait for A&E. Not sure that they can/would do much anyway. If you have full range of motion but just discomfort it doesn’t sound like there’s anything major out of whack or scaphoid (but IANAD, just have had thumb and finger breaks over the years)
You could also buy yourself an MCP thumb splint to provide some support and compression. (https://www.wristsupports.co.uk/wrist-supports-for-mcp-joint-irritation.html)

The thing that helps for me is to massage with germolene or ibuprofen gel to get some local pain relief and reduce inflammation.
Good luck with your next steps and recovery

Couldn’t you get a ‘new’ thumb injury less than 2 weeks old?

This.
I presented my 3yr old knee injury as a “new” injury. Turned out it was a ACL tear that needed surgery. Just go to AE and say you did it yesterday.

Was literally about to say the same as oldenough. If they can patch up all the drunks every weekend it’s not unreasonable to expect a genuine injury to be looked at.

Just go to AE and say you did it yesterday.

FFS! Please don’t do this.

Not only are you taking up an unnecessary place they can actually see from your records lying.

I’d return to minor injuries say the pain is getting worse and tell them you can’t see your GP until the end of April.

Or if your GP does online GP appointment booking use that, give as much detail as you can it’s possible they will look at it and refer you for an X-ray with a day or 2.

Not only are you taking up an unnecessary place they can actually see from your records lying.

Overall no more space than if the op had gone there in the first place. And who’s to say it hasn’t been “reinjured” again the day before. Obviously not ideal, but what is with the NHS.

I crushed two fingers after a simple fall was interrupted by a tree

The fingers seemed terrible. They looked deformed and didn’t bend. GP was concerned. X ray showed nothing. A different GP didn’t think it was a big deal

I pulled them bit further every day and generally rubbed and waggled them. All good now

Overall no more space than if the op had gone there in the first place. And who’s to say it hasn’t been “reinjured” again the day before. Obviously not ideal, but what is with the NHS.

But they made the right decision then not to go as it didn’t warrant it. Less so now. It’s an emergency department.

I work in an Emergency Department, and agree that it’s not an ideal situation. Hands, especially thumbs, are important, and there are some injuries that won’t heal without intervention- ulnar collateral ligament rupture, for example. GPs aren’t commissioned as a minor injury service- so what does the poor patient stuck in the middle do? I think it would be reasonable for a walk in centre too see you, image/treat/refer if necessary. It’s the sort of thing we see often in the ED and I’d be happy that it was appropriate (while clearly not an emergency) if you’d exhausted other avenues, although you’d be triaged as a low priority.This is common now for our work across a whole range of conditions as the health service slowly disintegrates, the only door that is open is the ED. If it was me I’d visit the local walk in centre, explain your ongoing pain/loss of function and delay to primary care availability and see if they can sort you out. Good luck.

(Incidentally, doesn’t sound like a scaphoid injury)

Could they do X-ray at the minor injuries and they told you to bog off or they just didn’t do X-ray ?

If it’s the first that is ridiculous because quite clearly that could end up costing the NHS much more in the long run telling you to go away

There is lots that can be done for thumbs, and they are crucial, they shouldn’t have told you to go away. As Drac says go back to minor saying it’s got worse. Personally I would go to A&E, it needs an X-ray regardless and it may as well be done by someone used to doing X-rays ie acute trust. Our trust wouldn’t be upset as you would be filtered straight to X-ray

The GP will see you the end of April, then refer you to acute hospital to use the same X-ray machine that A&E use.

Have you tried speaking to GP receptionist / gp . You don’t need to physically see the GP, just get them to refer you to X-ray / fracture clinic. Ask them if they have direct access pathways set up too.

other option is ring 111. In some areas they can do direct access or filter straight to X-ray etc… worth a try

Other option is to go private and pay £250 or so for an MRI.

I wonder if youve torn or snapped your ucl.
Can ypu tpuch all the tips of your fingers by moving your thumb to them, not the othrer way round
Make a circle witj you thumb and forefinger, insert a pen into the O
Get an assistant to pull the pen out the o whilst you hold it closed. Pen pops through = damaged u c l

I’m not sure what you think a doctor will do. It’s healing, it’s taking time. Keep moving it through its full range of motion so it doesn’t stiffen up. It will improve to some level but may never be quite as good as it was.

They ran an ultrasound over mine. Be waaaay cheaper than a mri check.
Even i could see the moving and non moving bit of tendon amd im not a doctor or ultrasound techie

Go see a good hand physio?
Immobilization to limit movement during daily tasks whilst undertaking appropriate mobilization exercises to manage inflammation might be on the cards.
Carry on as normal probably isn’t the best strategy.

Years ago I came off my bike riding into town. No explanation as to how or why, I had just turned off at the bottom of a hill onto a shared-use cycle path alongside a main road, at walking speed, and it was like someone grabbed both wheels and yanked them out from under me. My left knee pivoted out and took most of the impact, but I also hit my elbow, shoulder, the side of my face, putting a big graze across my cheekbone, but fortunately the peak of my Giro lid took the hit my head would have taken. I ignored it for some time, but after some months of my knee continuing to be painful, I made an appointment with my doctor. True to form, he wiggled my knee about a bit, shrugged and said, ‘well, you’ve done something, but you’re not getting any younger, so what do you expect’, and that was that. He was my mum’s doctor as well, she hated his dismissive and offhand manner too.

Forward several years, and my knee is becoming ever more uncomfortable and painful, so I made another appointment, asking to see another doctor. This time I got a young trainee doctor, who spent some time doing a lot more examining and manipulating of my knee, and frowning, and ended up saying, ‘you know, I really don’t like how that’s feeling, I’m booking you an x-ray at Bath RUH’.

Which showed the initial impact had resulted in osteoarthritis in two places under the kneecap, precisely under the impact point.
Which meant I could be prescribed appropriate NSAI’s, and exercises, and it’s officially on my records.
From my experience, I think it’s worth asking for at least a doctor’s opinion, and then seeing what they recommend, which may result in a hospital referral, but at least that won’t involve A&E, it’ll be a clinical appointment and assessment.

If it is an injury to the ulnar collateral ligament of the thumb MCP joint, then no, healing may not have occurred. Depending on the extent of the injury and the anatomy of the area, you can end up with a stener lesion, that by definition can’t heal without surgical intervention, there is also the possibility of an avulsion fracture. If you think it is the UCL then get a brace until you can get seen.

Although I applaud movement for injuries generally, if you’ve damaged ligamentous / capsular tissue then it’s always worth finding out the extent of the damage. A lack of protection and specific progressive loading can lead to long term instability at that joint, which can be somewhat bothersome a bit further down the line! 🙂

Agreed

After my 2nd u c l snappage the surgeon popped round to tell me that the operation went ok, i now had a pin and suture in place as the scarring had shrunk the tendon
He also advised that the joint would go arthritic within 5 or 6 years and need fusion. That was 10 years ago and do far its been ok

@teenrat

My local trust has an occupational hand therapy unit .. it’s basically physio to get hand movement back.
In my case (broken finger) I was referred from the fracture clinic which were referred by minor injuries/walk in.
It was explained to me the mobility was soft tissue and the bone was healing well…

Even at my age the exercises have proven really good and I can almost use the finger like before.

UTC/MIU is the place to be provided your locality has one.
This along with Fractures, foreign bodies, chest pains, swollen legs, back pain, infections, heart failure, labour, sepsis, social problems, dermatology, gynaecology, paediatrics, dislocations, amputated fingers, gp over spill, anxiety depression etc etc etc seems to be my day job since the NHS decompensated.
I see more AED in a UTC than when I work in AED! I love it all!

We have a 2 week old injury rule, but **** that, what are people meant to do!

The next gp appointment is on the 25th April.

that seems unlikely to me!  I’d suggest phoning the practice again – were you asking to see a specific GP or for a specific time of day?  Did you explain why you wanted the appointment (eg could the practice nurse take a look and refer you for X-ray or indeed with the history is the GP able to do that without waiting to see you).

even if all of those things are not possible there is usually a way to see a GP, such as turn up at 8am and wait indefinitely.  Sometimes they refer to those as “emergency appointments” our practice have stopped that as it was putting people off from seeing their GP who have a genuine need (people were waiting two weeks to discuss a potentially cancerous lump whilst anxious parents were using the emergency appointment for little Johnny’s sore throat).

nhs has too much demand, and vacancies running at 6%

in terms of thumbs you need to have ‘done a proper job’ on it
i ripped my thumb 5 weeks ago, went into minor injuries clinic at A&E, room of 20 people,
i got seen second within 10 mins, xray, thumb in sick carton of iodine for 5 mins, then asked if i could go to the big hospital, met a plastics consultant in 5 mins, ‘can you comeback for 7am tomorrow’ operated on 830am,
had 3 hand physio dept sessions since.

the nhs can be great at others times its terrible, i pulled an all nighter last summer, finally seen at 520am.
arrive 840pm

Think I’m going to.go down the private route. I’ll pay for an initial consultation with a specialist and see where that goes. Fed up of waiting now.

Don’t vote Tory?

I know it doesn’t help you right now but, this unfortunately, is the answer. If you want your taxes to end up in our public services instead of some crony’s already over stuffed bank account then we need to get the greedy pigs out of government

I had an otb that resulted in my thumb pointing the wrong way.   NHS was brilliant I was in the ED within 20 minutes of arrival. Has numerous x rays and a god slug of morphine when they put it back in the socket. By then end of the week I had seen the consultants in outpatients and had an operation to see the ligaments back on