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Having pain in finger. Become red. Applied Voltaren Gel. What can be done?

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Orthopaedic Surgeon
Practicing since : 1994
Answered : 10351 Questions
I'm writing to you on behalf of my female friend, 28 years old living in Europe.
2 weeks ago she woke up one morning with pain in her middle finger. The pain comes when the finger is bent and she tries to straiten it out (pic1), or if the finger has been straiten out for a while and she tries to bend it (pic2). The area of pain can be seen on pic3 marked with red. There is no pain when the finger is still.
One day she did massage the dorsal side of her hand (pic4, area beeing massaged is marked with red) and she felt like something popped in her hand. After that, the pain went away. She could go from having the finger bent to straiten it out without feeling any pain. However, this only lasted for a few hours and then the pain came back again.
What could be the problem here and what could we do about it? We already tried Voltaren Gel but without any luck.
Posted Wed, 20 Mar 2013 in Bones, Muscles and Joints
Answered by Dr. Praveen Tayal 1 hour later
Thanks for posting your query.
From the description provided, the most possible cause of pain is likely to be due to tendonitis. If she did not have an injury while playing or otherwise, then tendon or its sheath may become inflamed causing painful movements. Most common reason is a mild sprain that she must have sustained somehow.
She needs to give it some rest for a while, use hot fomentation twice a day and local ointment for pain relief. Avoid gripping and lifting objects altogether. Keep it in most comfortable position or use a splint/crepe bandage most of the time (including at night) for best results. Watch for worsening of symptoms like increase in pain, appearance of swelling and tingling numbness in fingers. If she gets any of these, visit the physician and get a check up done followed by investigations like X XXXXXXX or MRI.
It looks like it will resolve on its own in a couple of days. She can start taking mild anti inflammatory like ibuprofen thrice daily.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Please accept my answer in case you do not have further queries.
Wishing you good health.
Dr. Praveen Tayal.
Above answer was peer-reviewed by
Follow-up: Having pain in finger. Become red. Applied Voltaren Gel. What can be done? 10 hours later
Hi Doctor,

Thank you for the answer.

Is there any reason to suspect this might be tendovaginitis stenosans (also know as "Trigger Finger") ? Could you please give me your take on this and in what way we could examine this ourselves? Please get back if you need any input.

Best Regards
Answered by Dr. Praveen Tayal 52 minutes later
Thanks for writing again.
Trigger finger- Stenosing Tenosynovitis is more commonly seen if there is a prior history of joint pains. Sudden onset is less likely. The pain increases on inactivity and is relieved after exercise.The pain usually starts at the base of the finger and not the area that you marked red in the figure.
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 at rest.
However, a direct examination by an orthopedician is an integral part of diagnosis. A possibility of stenosing tenosynovitis needs to be considered.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Above answer was peer-reviewed by
Follow-up: Having pain in finger. Become red. Applied Voltaren Gel. What can be done? 31 minutes later
Hi Doctor,

Thank you for the quick answer.

You mention that Stenosing Tenosynovitis is more commonly seen if there is a prior history of joint pains, what joints are you referring to, joints in the hand/fingers or just any joints in the general?

If this should prove to be Stenosing Tenosynovitis, in your oppinion, what is the best treatment besides operation or cortison injection for "Trigger fingers" and is there a possibility that it could heal on its own?
Answered by Dr. Praveen Tayal 12 hours later
I was referring to the prior history of finger joints pain.
Most of the times, medicines- anti inflammatory drugs, regular physiotherapy and cortisone injection help in recovery. There are chances that the pain will be relieved after proper treatment. In few cases, surgical option may have to be considered if the response to conservative treatment is not satisfactory.
You can consult me again directly through my profile URL
Please accept my answer in case there are no further queries and recommend our services to your friends too if you have found it helpful.
I wish you the very best in whatever you do.
Warm regards
Above answer was peer-reviewed by
Follow-up: Having pain in finger. Become red. Applied Voltaren Gel. What can be done? 2 days later

Thank you for the answer.

We went to see a physician the other day to have the finger examined. He didn't seem to know what was wrong with the finger. He could not really tell if it was stenosing tenosynovitis or tendonitis. We did an X XXXXXXX on the finger but there was nothing wrong (or so he claimed). Overall, we didn't get anything usefull from our visit from this physician.

Your information so far has been usefull and now I just have some more questions to add.

The situation with the finger has not changed since I first wrote to you, but in addition we figured out that when pressing an area near the base of the finger (please see attached picture called "Hand1.jpg") you can feel a small bump going back and forth while bending and stretching the finger.

Could this be the beginning of stenosing tenosynovitis and is there anything that could be done to prevent it from getting worse, like using a splint?

Since the doctor we met did not know how to examine if this was stenosing tenosynovitis or not, is there anyway you could instruct us on how to examine the finger ourselves?

Thank you
Answered by Dr. Praveen Tayal 2 hours later
The small bump that you can feel at the base of the finger is likely to be a small cyst in the tendon sheath, most likely inflammatory in nature.
To prevent any further worsening, she can use a splint by bandaging the affected finger with her ring finger, taking physiotherapist once the acute pain subsides. The inflammation is likely to subside with these measures in two weeks if it is tendonitis.
In tenosynovitis, the sudden jerk on extending the finger persists.
It is best to consult an orthopedician or a hand specialist for differentiation as he might decide on giving steroid injection locally for relief.
Above answer was peer-reviewed by
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