Trigger finger is an excruciating condition that causes the finger or the thumb to catch or lock up when bent.
Also known as stenosing tenosynovitis, trigger finger occurs when the tendons in the finger or thumb becomes inflamed.
The tough tissue bands that connect the muscles and the bones are called tendons.
Together, the tendons and the muscles in the hands and arms bend and straighten the fingers and the thumbs.
Typically, the tendon will just easily glide through the tissue covering or the sheath because of the synovium.
It is the lubricating membrane surrounding the joint.
However, there will be instances when the tendon becomes inflamed and swollen.
When this happens, bending the finger or the thumb will pull the inflamed tendon through a tendon sheath that is already narrowed.
This would result to a snap or pop.
Depending on the severity, the treatment option can range from noninvasive options to trigger finger surgery.
Causes
Repeated movements and forceful use of the finger or thumb is often the culprit for trigger finger.
Rheumatoid arthritis, diabetes, and gout have also been associated with trigger finger.
There are several factors that increase one’s risk of developing the condition.
Some of the factors include the following:
- Repeated gripping – occupations and hobbies that entail repetitive hand use and prolonged gripping.
- Health problems – people with diabetes and rheumatoid arthritis are more at risk of developing trigger finger.
- Sex – trigger finger is more common in women than in men.
Symptoms
Common symptoms of trigger finger include the following:
- A bump or a nodule
- Tenderness
- Finger catching or locking
- Difficulty or inability to straighten the affected finger
- Finger is locked in bent position
- Stiffness of the affected finger especially in the mornings
- Popping and clicking sensation when the affected finger is moved
Diagnosis
When diagnosing trigger finger, no elaborate testing is required.
Checking the medical history and a physical examination would often suffice.
During the examination, the patient will be asked to close and open the hand.
This is done so the doctor can easily check for signs of locking.
The physical examination will also allow the doctor to check for lumps, areas of pain, and smoothness of motion.
Lumps associated with trigger finger will move together with the finger since it is attached to the tendon.
Treatment
Medications
NSAIDs or nonsteroidal anti-inflammatory drugs (ibuprofen and naproxen) are often recommended to provide relief from pain.
However, NSAIDs won’t be able to relieve the inflammation and the swelling.
Therapy
Noninvasive treatment approaches for trigger finger include the following:
- Rest – patients whose hobbies or work entail prolonged grasping and repetitive gripping, resting for at least 3 to 4 weeks will be recommended.
- Ice or heat – some individuals notice an improvement when icing the palm several times a day. Others on the other hand, observe an improvement when warm-water soaks are done first thing each morning.
- Splint – splinting the affected finger for at least 6 weeks might be recommended to help ensure it stays in an extended condition.
- Stretching exercises – in order to maintain mobility of the affected finger, doctors will most likely recommend gentle exercises.
Surgery and Other Procedures
For conditions that are severe and does not respond to conventional treatments, the following treatment routes might be suggested:
Percutaneous Release – after numbing the palm, the doctor will then insert a needle into the tissue in order to help break the constriction. This procedure is done under ultrasound so damage to the tendon and other nerves will be avoided.
Trigger Finger Surgery – the procedure is done by cutting open the constricted tendon sheath section through a small incision made in the base of the finger affected. This procedure is often carried out in the operating room.
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