Trigger finger, also called stenosing tenosynovitis, is a medical condition which causes one or more of the digits of the hand to catch or lock when bent. Stenosing tenosynovitis can affect any of the fingers or the thumb (trigger thumb). The affected digit may feel as if it is snapping into the bent position (like a trigger) or may become locked into position when the patient flexes the fingers to grip. The flexion is oftentimes associated with pain near the base of the finger by the palm. In severe cases of trigger finger, the digit may need to be manually moved into flexion or extension position. The orthopedic surgeons at OSMI Hand Therapy Center provide trigger finger treatment to Fort Worth, Cleburne, Decatur and the surrounding metropolitan area.
Symptoms include:
- Finger stiffness, especially after inactivity such as upon awakening
- Painful clicking or snapping sensation when flexing or extending the finger
- Inability to straighten the finger
- A nodule or tenderness at the base of the finger
Trigger finger often presents in the morning or upon attempting to firmly grasp an object.
What Causes Trigger Finger?
Trigger finger occurs when the tendons, which normally glide smoothly through the sheath that covers them, become irritated or inflamed. This inflammation interferes with the movement of the tendons through the sheath, impeding the flexion and extension of the finger.
Chronic inflammation can also cause scarring within the tendon sheath as well as nodules that can both be contributing factors to trigger finger. In many cases, the exact cause of trigger finger is unknown, however, there are certain factors that can put patients more at risk for developing the condition.
Risk Factors
Trigger finger is often the result of repetitive movement or trauma that can occur from activities such as gardening, farming, playing specific musical instruments, or performing industrial jobs that require prolonged gripping.
Other factors that can increase your risk include:
- Rheumatoid arthritis: Most patients with rheumatoid arthritis experience inflammation in the tendons which can develop into trigger finger.
- Diabetes: Diabetics often have joint and/or ligament conditions and are at higher risk for trigger finger.
- Gout: Inflammatory arthritis associated with gout can result in trigger finger.
- Surgery for carpal tunnel syndrome: Trigger finger can be a complication of carpal tunnel syndrome
Trigger finger typically presents in patients between the ages of 40 and 60 and affects more women than men.
Diagnosing and Treating Trigger Finger
Diagnosis of trigger finger can usually be made upon physical examination and a review of symptoms. Your orthopedic doctor will observe your hand as it flexes and extends, check for nodules and smoothness of motion, as well as ask you about pain and frequency of symptoms.
Treatment will depend on the duration and severity of symptoms and may include:
- Rest: If a repetitive movement is contributing to your trigger finger, avoiding that activity for a time can ease the condition.
- Oral anti-inflammatory medication: Over-the-counter medicines, such as ibuprofen or naproxen, can decrease the inflammation causing trigger finger and alleviate pain.
- Cold packs: Icing the affected area can help with swelling and pain. Be sure to follow instructions on proper ice treatment methods.
- Splinting: Wearing a splint at night that keeps the finger extended can help rest the tendon.
- Stretching exercises: The Hand Therapy Center at OSMI offers specialized therapists who create customized home exercise programs for all manners of hand and wrist injuries and disorders.
- Steroid injections: A local cortisone shot can be a fast and effective treatment to reduce inflammation from trigger finger and maintain mobility. Cortisone injections are one of the most common treatments for trigger finger and typically offer relief for at least a year. Some patients require more than one cortisone injection to see results.
- Percutaneous release: This in-office surgical procedure involves inserting a needle into the surrounding tissue of the tendon to break up the constriction and open the sheath.
- Surgery (rare): A small incision is made at the base of the affected finger and the tendon sheath is opened to allow the tendon to glide freely.
Trigger finger surgery is typically performed on an outpatient basis in an operating room and is only recommended if more conservative treatments are unsuccessful in relieving pain and reducing symptoms. If trigger finger surgery is necessary, recovery usually involves several weeks of splinting and physical therapy to regain full range of motion.
If you are experiencing symptoms of trigger finger, contact our team of hand, wrist and elbow orthopedic and sports medicine specialists that offer state-of-the-art treatment and highly personalized care, contact the OSMI office or call 817-529-1900 today!
