Q: I am a 77-year-old right-handed female and have developed a trigger finger in the middle finger of my left hand. At times it will lock in a down position and I manually pull it up but it seems to be getting worse. Please provide information on this subject.
A: A trigger finger, also known as stenosing tenosynovitis, occurs when any digit on your hand gets stuck in a bent position and straightens with a pop such as occurs with the trigger on a gun. It is more common in women than in men and in individuals with diabetes and most frequently involves the dominant hand. Oddly enough, you indicate you are right handed and the trigger finger is on the left, which is just opposite of what commonly occurs. Trigger finger occurs because of a narrowing of the sheath that surrounds the tendon of the affected finger or fingers. Tendons are fibrous cords that attach muscle to bone. Each tendon is surrounded by a sheath lined with tenosynovium which releases a lubricating type of fluid that helps tendons glide smoothly within their own protective sheath every time you flex your fingers, make a fist, or otherwise move your hand. When the tendon can’t glide through the sheath with ease because of inflammation, the finger will catch before straightening out. This tends to irritate the tendon and make the problem more complex.
Trigger finger is more common in individuals who perform routine maneuvers regularly, such as occurs when playing a musical instrument or from the course of employment when the hands may grip an item again and again throughout the day. It is also more common in those individuals diagnosed with rheumatoid arthritis, diabetes, hypothyroidis and other disorders.
Diagnosis is rather simple and can be determined when your physician asks the appropriate questions and performs an examination of the digit(s). Mild cases might be helped by performing finger exercises, splinting the affected finger for a month or longer, taping the affected finger to the neighboring finger, and, obviously, discontinuing (at least temporarily) any activity that requires you to place your hand in a clenched position. More serious cases might be helped by NSAIDS, non-steroidal anti-inflammatory drugs such as ibuprofen, a steroid injection, or as a last resort – surgery.
On the home front, consider massaging your hand and fingers whenever possible. Try soaking your hand in warm water, particularly in the morning when your hand may feel more inflamed and stiff. It might even feel good to wash your breakfast dishes in warm, soapy water in an attempt to loosen your hand joints and lessen the irritation. Lastly, rest your hand whenever possible. In my opinion, it’s always a good idea to try home remedies and over-the-counter medications before pulling out the big guns but be sure to speak with your physician prior to initiating anything that could exacerbate the problem you have.
