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
may occur when any of the four fingers of the hand attempts to flex closed while gripping. Instead of a smooth, continual closure, the digit
hesitates, then snaps closed. When attempting to extend the digit, a similar
hesitation may occur before it "snaps" into full extension. In severe cases, the
digits must be manually brought into full extension or flexion. The closure is frequently associated with pain at the base of the digit on the palm of the hand. Triggering
can also affect the thumb.
What causes trigger finger?
Trigger finger is caused by local swelling from inflammation or scarring of
the tendon sheath around the flexor tendons. These are tendons that normally pull the affected digit inward toward the palm (flexion). Usually, trigger finger occurs as an isolated condition
because of repetitive trauma. 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 suggested 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. Oral
antiinflammatory medications that may be helpful include naproxen, ibuprofen, diclofenac, and others.
The quickest and most effective treatment is a local cortisone injection
into the tendon sheath around the affected tendon. Most patients will respond
positively to the cortisone injection, but this may only be a temporary response. When a trigger finger persists after two injections and is not responsive to the above treatments, surgical procedures to
release the tendon sheath and/or remove the inflamed or scarred tissue are considered.
Surgical intervention is usually a permanent cure for this condition.
Medically reviewed by Aimee V. Hachigian-Gould, MD; American Board of Orthpedic Surgery
REFERENCE: Trigger finger (stenosing flexor tenosynovitis)