Will I be able to bend my thumb again?

Recently I woke to find that I couldn’t bend my right thumb. My middle finger was slightly swollen, too, and I had restriction in my jaw. The GP said I had trigger finger. Could you advise a cure?

TRIGGER finger occurs when the tendon that helps to move or flex the finger catches in the sheath it runs through.

The tendon is a cord-like structure that attaches the muscles to the bone. If the tendon or the sheath in which it runs become inflamed —which may occur through overuse, for example, and those with repetitive gripping actions are at increased risk of this — then there is not enough room for the tendon to glide through and it snags on the sheath.

This causes a sudden catching sensation and so — as in your experience — the finger locks when bent (known as state of flexion) and you can no longer straighten it.

Curiously, it is normally a painless experience.

This condition affects around two per cent of us at some stage of our lives, and it is most common in older women, though it is unclear why this is the case.

Triggering also occurs more commonly in those with type 2 diabetes, as high blood sugar may encourage inflammation, and in patients with rheumatoid arthritis, an inflammatory disease that affects not only joints, but tendons, too.

Typically the thumb, ring or little finger are affected.

I have some concern for you as you say you also have swelling of one middle finger along with restriction of your jaw.

This prompts the question: might a condition be evolving, such as polyarthropathy, which is an inflammatory disorder involving multiple joints?

At this stage, the pattern is not yet typical of anything like that.

But, if your symptoms become worse, then I would recommend you ask your GP for blood tests to look at, for example, inflammatory markers, including CRP (C-reactive protein), as this may suggest a more generalised inflammatory condition such as rheumatoid arthritis.

The initial treatment of trigger finger or thumb is conservative: splinting for four to eight weeks, to allow the tendon to ‘rest’ and for any inflammation to reduce.

THIS is supplemented, if necessary, with a regular non-steroidal antiinflammatory drug, such as ibuprofen, if not contraindicated for other reasons.

Research has shown that splinting leads to an improvement in more than 90 per cent of patients, many of whom experience full resolution as a result. The nurse at your practice can show you how to fix up a suitable splint, or a referral to a physiotherapist or occupational therapist can achieve the same end.

If this fails, then a one-off steroid injection mixed with local anaesthetic will bring about long-lasting and significant improvement in most cases.