Trigger Finger

Trigger Finger at a Glance

Trigger finger, or stenosing tenosynovitis, is a condition that is characterized by the inability to flex or extend the digit smoothly. All digits can be affected, but the ring finger is most often involved. The condition is characterized by the locking of your thumb or one of your fingers in bent position. The name trigger finger is from the symptom of triggering or snapping. Finger bones are connected to the muscles of the forearm by string like flexible connective tissues, called flexor tendons. These muscles pull on the flexor tendons, which then bend the finger joint.

Each tendon is surrounded by a protective sheath which is lined by a substance called tenosynovium. Tenosynovium releases a fluid to lubricate the tendons and facilitate their smooth gliding while bending or straightening the fingers.

If tenosynovium becomes inflamed due to its overuse or due to any inflammatory condition like rheumatoid arthritis or from repetitive strain injury, it causes narrowing of the sheath surrounding the tendon. As a result, the tendon is not able to glide smoothly and trigger finger occurs. Prolonged inflammation can cause thickening of the tendon and formation of nodules.

Risk factors

The risk factors of developing trigger finger include:

  • Age—trigger finger most likely occurs in people of age 40 to 60 years.
  • Gender—Women tend to develop trigger finger more than men.
  • Certain medical problems— Individuals with some medical problems like diabetes, rheumatoid arthritis, and hypothyroidism are at greater risk.
  • Repetitive gripping—Activities which involve repeated gripping for long times strain the hand and may cause trigger finger.

Symptoms

Symptoms of trigger finger may include:

  • Pain and stiffness in the affected finger
  • A tender nodule at the base of the finger
  • Popping or clicking sensation while bending or straightening the affected finger
  • Locking or catching of the finger in bent position which may suddenly pop straight
  • In severe cases, finger is locked in the bent position and is not straightened even with help

Diagnosis

Usually, trigger finger is diagnosed simply by physical examination only, no other tests are required.

Trigger Finger Treatment

Treatment of trigger finger can be non-surgical and surgical, depending on the severity of the symptoms.

Non-surgical Treatment

  • Resting and splinting—for mild symptoms, resting the finger so use of a splint to keep the finger in resting position may be enough.
  • Medications—anti-inflammatory drugs or a corticosteroid injection may be used if symptoms are moderate to severe.

Surgical Treatment

If non-surgical treatment options fail, your doctor may recommend surgery. The surgery is usually done under local anesthesia and does not require an over-night stay in the hospital. The aim of the surgery is to widen the tendon sheath so that it has enough space to glide through.

Recovery From Surgery

Some discomfort and soreness in the palm is normal. Your doctor may recommend that you elevate your hand above heart level; it will reduce pain and swelling. You will be able to move your fingers within a few hours after surgery. Physical therapy will help you regain strength and motion of your fingers. You may completely recover in a few weeks; however some swelling and stiffness may persist for about six months.

Sources

Mayoclinic.com
American Academy of Orthopaedic Surgeons