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Arthritis: Trigger Finger
Trigger finger and thumb are painful conditions that cause the fingers or thumb to catch or lock in a bent position. The problems often stem from inflammation of tendons located within a protective covering called the tendon sheath.
The affected tendons are tough, fibrous bands of tissue that connect the muscles of the forearm to your finger and thumb bones. Together, the tendons and muscles allow you to bend and extend your fingers and thumb, for example, as in making a fist.
A tendon usually glides quite easily through the tissue that covers it (also called a sheath) because of a lubricating membrane surrounding the joint called the synovium. Occasionally a tendon may become inflamed and swollen. When this happens, bending the finger or thumb may pull the inflamed portion through a narrowed tendon sheath, making it snap or pop.
What Causes Trigger Finger?
Trigger finger may be caused by highly repetitive or forceful use of the finger and thumb. Medical conditions that cause changes in tissues -- such as rheumatoid arthritis, gout or diabetes -- also may result in trigger finger. Prolonged, strenuous grasping, such as with power tools, also may aggravate the condition.
Who Gets Trigger Finger?
Farmers, industrial workers and musicians are frequently affected by trigger finger since they rely on their fingers or thumbs for multiple repetitive movements. Trigger finger is more common in women than in men and tends to occur most frequently in people who are between 40 and 60 years of age.
What Are the Symptoms of Trigger Finger?
One of the first symptoms may be soreness at the base of the finger or thumb. The most common symptom is a painful clicking or snapping when attempting to flex or extend the affected finger. This catching sensation tends to worsen after periods of inactivity and loosen up with movement.
In some cases, the finger or thumb that is affected locks in a flexed position or in an extended position as the condition becomes more severe, and must be gently straightened with the other hand. Joint contraction or stiffening may eventually occur.
How Is Trigger Finger Diagnosed?
No X-rays or lab tests are used to diagnose trigger finger. It is generally diagnosed following a physical examination of the hand and fingers. In some cases, the affected finger may be swollen and there may be a nodule, or bump, over the joint in the palm of the hand. The finger also may be locked in a flexed (bent) position, or it may be stiff and painful.
How Is Trigger Finger Treated?
The first step to recovery is to limit activities that aggravate the condition. Occasionally, your doctor may put a splint on the affected hand to restrict the joint movement. If symptoms continue, anti-inflammatory medications, such as ibuprofen or naproxen, may be prescribed. Your doctor may also recommend an injection of a steroid medication into the tendon sheath. If the condition does not respond to conservative measures or consistently recurs, surgery may be recommended to release the tendon sheath and restore movement.
How Long Does Recovery Take?
Recovery time depends on the severity of trigger finger, which varies from person to person. The choice of treatment also impacts recovery time. For example, splinting may be necessary for six weeks. However, most patients with trigger finger recover within a few weeks by resting and limiting the use of the affected finger and/or using anti-inflammatory medications.
Reviewed by the doctors at The Cleveland Clinic Department of Rheumatic and Immunologic Diseases.
SOURCE: American Academy of Orthopaedic Surgeons
ORENCIA® (abatacept) Important Safety Information
Indication and Usage
ORENCIA® (abatacept) is a prescription medicine that reduces signs and symptoms in adults with moderate to severe rheumatoid arthritis (RA), including those who have not been helped enough by other medicines for RA. ORENCIA may prevent further damage to your bones and joints and may help your ability to perform daily activities.
Important Safety Information About ORENCIA® (abatacept)
Before you receive treatment with ORENCIA, a lyophilized powder for intravenous infusion, you should tell your doctor about all your medical conditions, including if you:
- have any kind of infection even if it is small (such as an open cut or sore) or an infection that is in your whole body (such as the flu).
- have an infection that will not go away or a history of infections that keep coming back.
- have had tuberculosis (TB), a positive skin test for TB, or if you recently have been in close contact with someone who has had TB. If you get any of the symptoms of TB (a dry cough that doesn’t go away, weight loss, fever, night sweats), call your doctor right away. Before you start ORENCIA, your doctor may examine you for TB or perform a skin test.
- have or have had viral hepatitis. Before you use ORENCIA, your doctor may examine you for hepatitis.
- have a history of chronic obstructive pulmonary (lung) disease (COPD).
- are scheduled to have surgery.
- are allergic to any of the following ingredients in ORENCIA: abatacept, maltose, monobasic sodium phosphate, or sodium chloride for administration.
- recently received a vaccination or are scheduled for any vaccination.
- have diabetes and use a blood glucose monitor to check your sugar levels. The infusion of ORENCIA contains maltose, a sugar that can give falsely high blood glucose readings with some monitors on the day you receive your infusion. Your doctor may tell you to use a different way to monitor your blood sugar levels.
- are pregnant, planning to become pregnant, or are thinking about becoming pregnant. It is not known if ORENCIA can harm your unborn baby.
- are breast-feeding. You will need to decide to either breast-feed or receive treatment with ORENCIA, but not both.
- take any other kinds of medicine, including prescription and nonprescription medicines, vitamins, and herbal supplements.
- are taking other biologic medicines to treat RA such as: Enbrel® (etanercept), Humira® (adalimumab), Remicade® (infliximab), Kineret® (anakinra) or Rituxan® (rituximab). You may have a higher chance of getting a serious infection if you take ORENCIA with other biologic medicines.
Possible Side Effects of ORENCIA® (abatacept)
ORENCIA can cause serious side effects including:
- Serious infections. Patients receiving ORENCIA have a higher chance of getting infections including pneumonia, and other infections caused by viruses, bacteria, or fungi. Call your doctor immediately if you feel sick or get any of the following signs of infection: fever, feel very tired, cough, feel flu-like, or warm, red or painful skin.
- Allergic reactions. Allergic reactions can happen on the day of treatment or the day after receiving ORENCIA. Tell your doctor or get emergency medical help right away if you have hives, swollen face, eyelids, lips, tongue, throat, or trouble breathing.
- Cancer (malignancies). Certain kinds of cancer have been reported in patients receiving ORENCIA. It is not known if ORENCIA increases your chance of getting certain kinds of cancer.
- Vaccinations. You should not receive ORENCIA with certain types of vaccines. ORENCIA may cause some vaccinations to be less effective.
- Respiratory problems in patients with COPD. You may get certain respiratory problems more often if you receive ORENCIA and have COPD, including: worsened COPD, pneumonia, cough, or trouble breathing.
The more common side effects with ORENCIA are headache, upper respiratory tract infection, sore throat, and nausea.
Please read the Patient Information in the Full Prescribing Information below.
ORENCIA is a registered trademark of Bristol-Myers Squibb Company.
All other trademarks are property of their respective companies.
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