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.
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.
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.