Trigger Finger/ Trigger Thumb
Cause: Each flexor tendon that bends the finger passes through a fibrous tunnel as it travels to the fingertips. Increasing age and wear and tear slows the body’s ability to repair itself, and over time, the tunnel tightens and the tendon swells into a nodule. When the finger straightens, triggering occurs as the swollen tendon nodule pops through the tight tunnel. Eventually, the finger becomes locked and permanently immobile.
Symptoms: Swelling and stiffness of digits, pain in the back of the fingers.
Common affected areas: All digits of both hands can be affected, with the thumb, ring and middle fingers being the most prevalent. Diabetics and patients with renal disease tend to have more severe cases of trigger digits.
Treatment: Modifying hand activities, splinting the finger for enforced rest, non-steroidal anti-inflammatory medication, ultrasound, and heat and laser therapy. Steroid injection into the tendon is an option as well.
Carpal Tunnel Syndrome
Cause: Compression of the median nerve at the wrist
Symptoms: Intermittent tingling and numbness in the fingers and hands, and occasional pain or burning sensation radiating to the arm. In the later stages, there is less sensitivity to touch, more dropping of small objects, weakened thumb muscles and increased clumsiness.
Treatment: Restrict activities that tax the hand, use of a wrist brace, Vitamin B complex, non-steroidal anti-inflammatory medication, steroid injection for temporary relief of swelling. Surgery in cases of severe nerve compression.
Cause: Loss of cartilage at the ends of the bones.
Symptoms: Stiffened joints (especially in the morning) and crepitus. Acute pain and swelling may occur in the affected joint following strenuous activities.
Common affected areas: Distal Interphalangeal Joints (DIPJ) of the digits and Carpometacarpal Joint (CMCJ) of the thumb. These joints will become prominent and there may be growth of ganglion or mucous cyst.
Treatment: Anti-inflammatory medication, adequate rest and soothing warm towels or splints to immobilise the joints. In more severe cases, joint fusion surgery or joint replacement surgery may be performed.