DEAR DR. ROACH: My healthy 91-year-old mother recently discovered that she has a diagnosis of trigger finger. She is hesitant to do surgery, but is hoping for more mobility in her hand. What are some of the best options for an independent woman at her age? — M.B.
ANSWER: Stenosing flexor tenosynovitis, more commonly known as “trigger finger,” is a common issue, especially for people in their 40s and 50s, somewhat more common in women. (It’s called trigger finger because the finger gets stuck in the flexed position, and when it is straightened out, it snaps like a trigger being pulled and released.) The condition often starts out painless, but may progress to painful episodes, or even being unable to “unlock” the finger. Some people have more than one finger affected.
There are many strategies for conservative management. One that has data behind it is splinting the affected finger, which is effective in many people, but it may take 6 to 10 weeks. Avoiding activities that have caused the condition (pinching the fingers is a common one) may help. I have had readers write in to tell me that moving the finger (one person said underwater) helped, and quite a few have written me to say that the condition just went away after a year or two.
I refer people who continue to have symptoms despite conservative management to a hand surgeon, who can inject an anti-inflammatory steroid into the sheath the tendon goes through to try to keep the tendon from getting stuck. Although hand surgeons can treat this surgically, I have not had a patient have to go through the operation very often, as most people will get better by the third injection.
