What Are The Symptoms & Treatments of Trigger Finger?
What Is Trigger Finger?
Trigger finger is a painful condition that makes your fingers or thumb catch or lock when you bend them. It can affect any finger or more than one finger at a time. You can also have it in both hands. You might hear it called Stenosing Tenosynovitis. It is sometimes also called “trigger thumb.” The tendons that bend the fingers glide easily with the help of pulleys. These pulleys hold the tendons close to the bone. This is similar to how a line is held on a fishing rod Trigger finger occurs when the pulley becomes too thick, so the tendon cannot glide easily through it.
Trigger Finger Symptoms
Symptoms often start mild and get worse over time. It’s more likely to happen after a period of heavy hand use than after an injury. It’s often worse:
- In the morning
- When you grasp something firmly
- When you try to straighten your finger
Trigger finger may start with discomfort felt at the base of the finger or thumb, where the finger joins the palm. This area is often sensitive to pressure. You might feel a lump there. Other symptoms may include:
- A painful clicking or snapping when you bend or straighten your finger. It is worse when your finger’s been still, and it gets better as you move it.
- Stiffness in your finger.
- Soreness or a bump at the base of the finger or thumb. Your doctor will call this a nodule.
- A popping or clicking as you move your finger
- A locked finger that you can’t straighten
Causes of Trigger Finger
Most of the time, it comes from a repeated movement or forceful use of your finger or thumb. It can also happen when tendons — tough bands of tissue that connect muscles and bones in your finger or thumb — get inflamed. Together, they and the muscles in your hands and arms bend and straighten your fingers and thumbs.
Trigger fingers are more common with certain medical conditions such as rheumatoid arthritis, gout and diabetes. Repeated and strong gripping may lead to the condition. In most cases, the cause of the trigger finger is not known.
A tendon usually glides easily through the tissue that covers it (called a sheath) thanks to the synovium, a membrane that surrounds joints and keeps them lubricated. Sometimes, a tendon gets inflamed and swollen. Long-term irritation of the tendon sheath can lead to scarring and thickening that affect the tendon’s motion. When this happens, bending your finger or thumb pulls the inflamed tendon through a narrowed sheath and makes it snap or pop.
Trigger Finger Risk Factors
Things that make you more likely to have trigger finger include:
- Age. It usually shows up between ages 40 and 60.
- Sex. It’s more common in women than men.
- Health conditions. Diabetes, gout, and rheumatoid arthritis can lead to trigger finger.
- Job. It’s common among farmers, industrial workers, musicians, and anyone else who repeats finger and thumb movements.
- Surgery for carpal tunnel syndrome. It’s most common in the first 6 months after your operation.
Trigger Finger Diagnosis
There are no X-rays or lab tests to diagnose trigger finger. Your doctor will do a physical exam of your hand and fingers, and they’ll ask about your symptoms.
Trigger Finger Treatment
The goal of treatment in trigger finger is to eliminate the swelling and catching/locking, allowing full, painless movement of the finger or thumb.
Common treatments include, but are not limited to:
- Night splints
- Anti-inflammatory medication
- Changing your activity
- Steroid injection
If non-surgical treatments do not relieve the symptoms, surgery may be recommended. The goal of surgery is to open the pulley at the base of the finger so that the tendon can glide more freely. The clicking or popping goes away first. Finger motion can return quickly, or there can be some stiffness after surgery. Occasionally, hand therapy is required after surgery to regain better use.
Treatment depends on how severe your symptoms are. Most of the time, you’ll start with:
- Rest. Try not to move the finger or thumb. You may need to take time away from the activity that’s causing the problem. If you can’t quit, you might try padded gloves.
- Splints. Your doctor can give you one designed to keep your finger still.
- Stretching exercises. These gentle moves may ease stiffness and improve range of motion.
- NSAIDs. Your doctor may suggest over-the-counter drugs that fight inflammation, like ibuprofen or naproxen.
- Steroid injections. They might give you a steroid shot into the tendon sheath. It can keep your symptoms at bay for a year or more, but you could need two shots to get results.
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