Health Do you have a problem youd like answered? If so, write to us at: Inspire magazine, 1 Cambridge Technopark, Newmarket Road, Cambridge CB5 8PB or email here Ask the doctor Whether its a health niggle or emotional problem, Inspires dR sARAH JARvis gets straight to the point Q A few months ago, when i woke in the morning, the middle finger of my left hand locked up at the first knuckle joint like a claw. Half an hour later the problem disappeared, only to return the next morning when i woke up. What could it be and what should i do? Lou Kemp, Watford dr sarah jarvis answers: It sounds as if you may have a trigger finger, which commonly affects your middle or ring fingers, or your thumbs. Its caused by inflammation of the protective sheath that surrounds your tendons nonstretchy cords of fibrous tissue that attach your muscles to the bone at one end. That means the tendon, which usually slides smoothly through the sheath when you bend or stretch a finger, can get caught. Symptoms are often worse in the morning, and range from stiffness, clicking and catching in the bent position, to being completely locked in a claw. It can be made worse by holding something tightly or straightening your finger. You may find you have a tender lump on your palm at the base of your middle finger. This is caused by scar tissue from inflammation. Trigger finger is more common in women than men, and your risk is higher if you do a lot of repetitive gripping movements. Cleaning, gardening, serious tennis or DIY can all cause inflammation. You may not be surprised to hear that having rheumatoid arthritis makes you more prone to trigger finger, but so can diabetes and osteoarthritis. Rest, stretching exercises or a splint to keep your finger straight at night may help settle the problem in mild cases. If youre in pain, anti-inflammatory tablets are worth considering. If these dont do the trick, your doctor may suggest a steroid injection to reduce inflammation (this is less effective in people with diabetes). As a last resort, you may be referred for surgery. You can contact Arthritis Cares free Helpline on 0808 800 4050 for an informal chat in confidence. Were open Monday-Friday, 09:30-17:00. For more information, visit arthritiscare.org.uk/ exerciseandarthritis Q my knee problems have got worse and im in pain. i take glucosamine and chondroitin, and live in a house full of stairs. the stairs are good for my heart and lungs, but what about my knees? Simon Keane dr sarah jarvis answers: Osteoarthritis is the most common cause of joint problems in the UK, and its the knees and hips that are most often affected. But there are other causes of knee pain, so its worth going to your GP for a check up. If you do have osteoarthritis, exercise is undoubtedly one of the most effective ways of reducing your risk of further problems. While contact sports such as rugby carry a risk of knee injury, which in turn can lead to osteoarthritis, doctors now recognise that limiting exercise reduces mobility and muscle strength, making symptoms worse. Youre also more likely to put on weight if you dont exercise, and this is a major risk factor for osteoarthritis. However, not all exercise is the same. For instance, you may find isometric exercise (such as straight leg raises) particularly helpful for strengthening your quadriceps muscles, without putting strain on your joints. Very highimpact exercises, such as running on hard surfaces with poor shoes, should be avoided. National guidelines now focus on group exercises your GP should be able to refer you to a physiotherapist for these. Alternatively, you can find a comprehensive list of exercises with accompanying videos on how to do them at patient.info, or visit arthritiscare.org. uk/exerciseandarthritis As for supplements, there is limited evidence that cod liver oil helps in osteoarthritis, although the evidence is stronger in the case of rheumatoid arthritis. Glucosamine studies are variable there are several brands all made in different ways, and most have not been shown to be better than placebo. Chondroitin has been shown to be as effective as at least one nonsteroidal anti-inflammatory drug (NSAID), although there are many brands available and a lot of variation between them. It may be worth trying GOPO, a supplement based on rosehip, as studies have shown reductions in both lowerback and knee pain and stiffness.