Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Trigger finger is a "snapping" condition of any of the digits of the hand when opened or closed. Trigger finger is medically termed stenosing tenosynovitis.
What are symptoms of trigger finger?
Symptoms of trigger finger develop when either the ring, middle, or index finger attempts to flex closed while gripping. Instead of a smooth, continual closure, the digit stutters, then snaps closed. The closure is frequently associated with pain at the base of the digit on the palm of the hand. Trigger finger can affect the thumb.
What causes trigger finger?
Trigger finger is caused by local swelling from inflammation or scarring around the tendons that normally pull the affected digit inward toward the palm (flexion). Usually trigger finger occurs as an isolated condition. Sometimes trigger finger is an associated condition resulting from an underlying illness that causes inflammation of tissues of the hand, such as rheumatoid arthritis. In fact, data presented at the 2005 American College of Rheumatology national meeting suggests that a majority of patients with rheumatoid arthritis have inflammation around the tendons of the palm of the hand that could develop into trigger finger.
What is the treatment for trigger finger?
Stretching, ice, and anti-inflammation treatments can be helpful. Medications that have been used include naproxen, ibuprofen, diclofenac, and others.
The most rapidly effective treatment is a local cortisone injection around the affected tendon. Most patients will respond to the cortisone injection. When a trigger finger persists after two injections and is not responsive to the above treatments, surgical procedures to ultimately remove the inflamed or scarred tissue are considered.
Corticosteroids are a class of medications that are related to cortisone, a steroid. Medications of this class powerfully reduce inflammation. They are used to reduce the inflammation caused by a variety of diseases. Cortisone is one type of corticosteroid. For the purpose of this review, "cortisone" is used interchangeably with "corticosteroid."
Corticosteroids can be taken by mouth, inhaled, applied to
the skin, given intravenously (into a vein), or injected into the tissues of
the body. Examples of corticosteroids include prednisone and prednisolone (given by mouth), methylprednisolone sodium succinate injection
(Solu-Medrol) (given intravenously), as well as triamcinolone,
Kenalog, Celestone, methylprednisolone
(Depo-Medrol), and others (given by injection into body tissues). This
article describes the role of cortisone injections into the soft
tissues and joints.
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