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Why does my palm get stiff in the morning?

Q: I am a 53 years old woman whose left palm becomes stiff at nights/early morning. I find it difficult to fold it. The ring finger joint remains stiff. On trying to walk after sleeping or sitting, the soles of my feet feel stiff but after sometime I can walk normally. Could it be onset of arthritis?

A:From your description you seem to have what is known as trigger finger. This is a condition in, which the ring finger gets stiff especially in the morning and then it gradually opens up. However, the finger at times opens with a snap somewhat like the trigger of a revolver. Hence the name trigger finger. We normally exclude systemic illnesses like arthritis, diabetes, thyroid disorders in some of these patients but that is based on clinical assessment. The treatment is either medical or surgical. Medical treatment is usually given in the early phase by giving some non-steroidal anti-inflammatory drug - Diclofenac Sodium or Ibuprofen. If this does not work, some people like to give a small steroid injection locally. I am never comfortable with this as:

  1. There is a distinct risk of infection, therefore this should always be given under strict aseptic conditions preferably in the operation theatre.
  2. In diabetics, this risk is higher and you could land in a greater mess.
  3. Injection of steroid in to a tendon can lead to a delayed tendon rupture.
Therefore, if it is intractable I prefer to operate, which is a small day care procedure and the symptom is relieved.

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