Trigger finger or also called the stenosing tenosynovitis is a medical condition in which a finger is stuck in a bent position. The finger can suddenly snap straight or bend drastically, imitating the pulling and releasing of a trigger.
A trigger finger occurs because of inflammation in the finger, which reduces within the sheath, surrounding the tendon of the concerned finger. The condition can be easily treated; however, if the problem is intense, it can lead the finger to become locked in a bent position for a lifetime.
People who are engaged in professions or have hobbies that require them to perform repetitive gripping actions are more prone to developing this condition. A trigger finger is very common in women and people with diabetes. The type of treatment varies per the severity of the condition.
Symptoms of trigger finger
Depending on the case, the symptoms of a trigger finger can range from mild to severe. Some common signs of a trigger finger include:
- Stiffness in the fingers, especially in the morning after waking up
- A pop or a click sound or sensation upon the movement of the finger
- Tenderness at the base of the affected finger
- A bump in the palm – at the base of the impacted finger
- Unable to straighten a finger, which is locked in a bent position
Trigger finger can impact any of the five fingers of the hand, including the thumb. Also, it can affect more than one finger at a time and could also include both hands. The condition is usually very severe in the morning hours, typically while attempting to grasp an object or straightening the affected finger.
A person should seek immediate medical attention if the finger feels too hot or is inflamed. This could also indicate a possible infection.
Causes of trigger finger
Tendons of the fingers are cords that link the muscle of the fingers to the bones. Each tendon is covered by a protective layer, known as a sheath. A trigger finger occurs when this protective layer of the tendon is inflamed or irritated due to any reason. The problem disturbs the usual gliding of the tendon through the sheath and tends to cause pain, bending of the finger, stiffness, etc.
If the problem persists for a long period, it can lead to scarring, thickening, and development of bumps in the tendon, which will further aggravate the issue.
Risk factors of trigger finger
Some people are at a higher risk of developing trigger finger condition. However, the problem can occur in people of all ages and gender. Some risk factors include:
- Occupations and hobbies that require regular gripping, repeated use of hands, and extensive pressure on the fingers can increase the chances of the person developing a trigger finger.
- Trigger finger is a common issue in women. Men are less prone to this medical condition.
- Trigger finger can also occur as a complication of the carpal tunnel syndrome surgery, especially in the first six months post the surgery.
- People suffering from rheumatoid arthritis are at a higher risk of developing the issue.
Diagnosis of trigger finger
The doctor does not need extensive testing or diagnostic exams to detect a trigger finger. The healthcare provider can conduct an assessment based on the medical history and the physical exam. In the physical exam, the patient would be required to move the finger, bend and straighten the affected joint to identify areas of pain, the stiffness, smoothness in movements and the existence of locking.
The doctor will also apply pressure on the palm to check for a lump. If there is a lump present in the palm, it will move along with the finger since it develops in the swollen area of the tendon.
Treatment of trigger finger
Trigger finger can be easily treated provided it receives the care in due time. The type of treatment depends on the severity and duration of the problem. Some methods used to treat trigger finger include:
Therapy: Non-invasive method such as therapy can be used to treat the trigger finger condition. These include:
- Resting the affected area and avoiding activities that involve repeated gripping, grasping or extended use of machinery that sends out vibrations.
- The doctor can also advise wearing a splint to support the affected finger to stay in an extended position for six weeks.
- Exercising as suggested by the doctor to restore mobility of the finger.
Steroid injection: This involves treating the affected finger or the tendon directly withsteroid medication to minimize swelling, allowing the tendon to glide smoothly like before. However, this treatment lasts for one year or slightly more in some cases. After which, a repeat procedure may be required if symptoms appear again. In the case of people with diabetes, steroid injections are not that useful.
Percutaneous release: In this method of treatment, the doctor numbs the affected palm and then inserts a strong needle into the tissue surrounding the tendon of the affected finger. The doctor then moves the finger and the needle to remove the blockage that constricts the smooth gliding of the tendon. This procedure is performed under the ultrasound guidance to help reach the right tendon, without harming the surrounding tendon sheaths.
Surgery: In most severe cases of tendon finger, the doctor can also recommend surgery to treat the condition. In this, the healthcare provider makes a small incision at the base of the affected finger to open the affected area of the tendon sheath. The constricted part is then relieved, allowing the tendon to glide smoothly.
Overall, a trigger finger is an uncommon condition but can be treated easily, if it occurs. Only in very severe and rare cases, does a patient need an invasive method such as surgery.