What is trigger finger?
Trigger finger, also known as stenosing tenosynovitis, is a condition in which the fingers or thumbs catch or lock in a bent position. This occurs when the tendon that controls the affected finger can’t glide smoothly in the sheath that surrounds it. Over time, the flexor tendon can become inflamed and may develop a small nodule on its surface, causing further aggravation.
Trigger finger can cause pain and stiffness at the base of the affected finger, especially when bent or straightened. Other symptoms may include clicking or popping when the finger is moved, often with difficulty straightening the finger once it has been bent. This condition can affect any finger, including the thumb (trigger thumb). Sometimes more than one finger may be affected at a time, but most commonly in the ring finger and thumb.
Symptoms of trigger finger
Symptoms of trigger finger often come on gradually and may get worse over time. Some people may have had the condition since birth, while others have developed it following an injury or from a period of extensive hand use. The constant back-and-forth motion increases the irritation and can cause a small lump of tissue, called a nodule to form on the tendon. This makes it even harder for the tendon to glide smoothly. It is often worse when trying to straighten or bend the finger. Symptoms are usually worse in the morning.
Trigger finger symptoms may include:
- A popping or clicking sensation as the finger moves
- Pain when bending or straightening the finger
- Finger stiffness
- Tenderness or a prominent bump at the base of the affected finger
- Catching or locking of the finger in a bent position, and may suddenly pop straight
Anatomy
Within the hands are long cord-like structures, called tendons that connect the muscles to bones. When the muscles contract, the tendons pull the bones, causing the finger to move. The tendons found within the palm of the hand help in bending the fingers and are called flexor tendons. Each tendon in the hand passes through and is surrounded by a protective sheath known as the tendon sheath.
Along the tendon sheath, bands of tissue called pulleys hold the flexor tendons to the bones in the finger’s bones, helping the fingers flex and extend. At the base of each finger where the digit meets the palm, is a pulley called the A1 pulley.
Trigger finger occurs when the tendon sheath or A1 pulley in the affected finger becomes irritated and swollen. This makes it harder for the tendons to glide through the sheath. Scarring or thickening of the tendon sheath can develop after long-term irritation, which can affect the tendon’s full motion. When this occurs, bending your finger or thumb pulls the inflamed tendon through a narrowed sheath, making it snap or pop.
What causes trigger finger?
Trigger finger is commonly caused by repetitive motions of the fingers and hands, such as from typing or gripping tools. In many people, there may be no explanation for the development of trigger finger.
People who have certain medical conditions such as diabetes or rheumatoid arthritis are at higher risk of developing trigger finger. Other risk factors can include age, commonly in adults over 40 and tends to affect women more than men. While trigger finger is more common in older individuals, children can have a condition called congenital trigger thumb that can result in locked flexion of the thumb.
Treatment for trigger finger
Treatment for trigger finger varies depending on its severity and duration. A diagnosis may be made by your doctor through a physical exam to determine the best treatment plan. Conservative treatments involving rest, anti-inflammatory medications, gentle stretching, and splinting of the affected finger may be all that is necessary. Corticosteroid injections may help as well, but in some cases, surgery to release the trigger finger may be necessary to release the tendon.
When nonsurgical treatments do not provide relief, your doctor may recommend surgery. This decision is typically based on the degree of pain or loss of function in the affected finger. If your finger or thumb is stuck in a flexed or bent position and cannot be straightened with gentle manipulation, surgery may be recommended to prevent permanent stiffness. Trigger finger release surgery is usually done with a local anesthetic and is quick outpatient procedure.
The goal of the procedure is to release the A1 pulley, so that the flexor tendon can glide more easily through the tendon sheath. A small incision is made in the palm of the hand below the affected finger. The A1 pulley is divided, or released, allowing the flexor tendon to glide freely. This will relieve pain and take away the clicking and catching sensation that creates trigger finger.
Is trigger finger preventable?
Preventing trigger finger from happening may not be completely avoidable, however, if your job involves a large amount of hand use, there are steps you can take to help prevent it. To avoid developing the condition, activities that involve repetitive motions of the fingers, such as typing or gripping tools, should be done with proper technique and posture. Taking breaks during activities can also help reduce strain put on the tendons in the hands and fingers. Additionally, if you have existing medical conditions, such as diabetes, it is important to manage them properly to reduce the risk of developing trigger finger.
If trigger finger persists despite these preventive measures, it is important to seek medical attention. Your doctor can recommend an appropriate treatment plan to help relieve your symptoms and prevent further complications. Stretching or splinting the affected finger may help as well. With the proper care, trigger finger can be effectively managed.
FAQ
Q: What is trigger finger?
A: Trigger finger is a condition in which the fingers or thumb catch or lock in a bent position. This occurs when the tendon that controls the affected finger can’t glide smoothly in the sheath that surrounds it. When the tendon that controls the bending and straightening of the fingers becomes inflamed and swollen, it becomes difficult to move them.
Q: Symptoms of trigger finger
A: Symptoms of trigger finger may include pain and stiffness at the base of the affected finger, especially when it is bent. Other symptoms may include clicking or popping when the finger is moved, and difficulty straightening the finger once it has been bent.
Q: What causes trigger finger?
A: Trigger finger is commonly caused by repetitive motions of the fingers and hands, such as typing or gripping tools. Other risk factors can include age (it is more common in adults over the age of 40), gender (it is more common in women than men), and certain medical conditions, such as diabetes and rheumatoid arthritis. While trigger finger is more common in older individuals, children can have a condition called congenital trigger thumb that can result in locked flexion of the thumb.
Q: How is trigger finger treated?
A: Treatment for trigger finger varies depending on its severity and duration. Treatment typically involves rest, anti-inflammatory medications, stretching, and splinting of the affected finger. Corticosteroid injections may help as well, but in some cases, surgery to release the trigger finger may be necessary to release the tendon. Trigger finger release surgery is usually done with a local anesthetic and is a short procedure.
Q: What is recovery from trigger finger release surgery like?
A: It is common to have some soreness in your palm after surgery. Your incision will heal within a few weeks, but it may take 4 to 6 months for the swelling and stiffness to go away completely.
Your doctor may recommend seeing a physical therapist if stiffness, swelling, or pain persist longer. It is important to follow your doctors’ instructions following surgery, to help recover fully.
Q: Can trigger finger heal on its own?
A: In some cases, trigger finger can heal on its own without any treatment. However, it is important to speak to your doctor for an appropriate treatment plan that can help relieve symptoms and prevent further complications. Often, trigger finger can be treated with conservative measures such as rest, ice, anti-inflammatory medications, stretching and splinting.
Q: Can you prevent trigger finger?
A: Prevention is key when it comes to trigger finger, although some cases may not be fully avoidable. To help prevent the condition, activities that involve repetitive motions of the fingers, such as typing or gripping tools, should be done with proper technique and posture. It is important to take regular breaks during activities to help reduce strain on the tendons in the hands and fingers. Additionally, if you have existing medical conditions, such as diabetes or rheumatoid arthritis, it is important to manage them properly to reduce the risk of trigger finger.
If trigger finger persists despite these preventive measures, it is important to seek medical attention.
Q: What will happen if a trigger finger is not treated?
A: If trigger finger is left untreated, it can become worse over time and cause permanent stiffness in the affected finger. Additionally, trigger finger can lead to further complications, such as trigger thumb. It is important to talk to an orthopedic surgeon if trigger finger persists, despite taking preventive measures. Your doctor can recommend an appropriate treatment plan for your specific case in order to help relieve your symptoms and prevent further complications. With the proper care, trigger finger can be effectively managed.
If you would like to schedule a consultation with Dr. Giang to find a treatment plan for your trigger finger, please give us a call or request an appointment using the form below.
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