Trigger Finger Health Article

Treatment

Initial treatment for mild or infrequent symptoms of trigger finger include rest, avoiding or modifying those activities that caused the inflammation, and the use of a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen. This may relieve the swelling and inflammation that resulted in the constriction of the sheath and the restriction of the tendon. Injection of a steroid medication (cortisone) into the tendon sheath is the next option to treat trigger finger. Depending on the severity, there may be one more injection a week later. Two-thirds of patients improve after one injection. Some physicians will splint the finger in extension after the injection.

In severe cases that do not respond to injections and the finger or thumb remains in a locked position, surgery may be required to relieve the symptoms. A local anesthetic is used for the surgical procedure performed on an outpatient basis. An incision is made by a surgeon in the palm of the hand at the base of the affected finger or thumb to relieve the constriction of the tendon. Recovery may take up to four weeks. Sometimes physical therapy of the hand is required after surgery to regain good use.

Alternative treatment

Treatment should begin when a person starts having difficulty moving the fingers. If started early, noninvasive measures have a good chance for success. Alternative treatments include acupuncture to facilitate healing and microcirculation, pulsed ultrasound, and myofascial release work for the affected area.

Prognosis

At least half of cases can be cured non-surgically. The key to successful treatment is early intervention. A mistake people make is trying to work through the pain. Diabetics have a higher incidence of the condition and are sometimes left with a disability.

Prevention

Taking frequent breaks from a repetitive activity will do much to prevent the condition. Depending on the intensity, that may mean a 10 minute break every hour from the repetitive activity. The break should be spent stretching the hands and arms and generally moving around.

PERIODICALS

"Ask the Mayo Physician." HealthOasis Mayo Clinic (May 4, 2000).

Phillips, D. F. "New Paradigms Sought to Explain Occupational and Environmental Disease." JAMA (January 6, 1999).

Stroud, R. "Minimally Invasive Surgical Techniques of the Hand and Upper Extremities." Orthopedic Technology Review (September 2000):18.

ORGANIZATIONS

American Society for Surgery of the Hand. 6300 N. River Rd., Suite 600, Rosemont, IL 60018. <http://www.hand-surg.org>.