Trigger finger, officially known as stenosing tenosynovitis, is a common problem that affects the fingers and thumb. It can occur in one or multiple fingers at a time, and can be caused by numerous factors. Treatments can range based on the severity of the condition. If you’re having the following symptoms that interfere with your daily life, you may wish to consult a doctor:
Signs and Symptoms
Symptoms of trigger finger occur gradually over time. Here are a few common signs and symptoms that you may be developing trigger finger:
- Pain or stiffness at the base of the finger, particularly in the morning
- Popping or clicking as you move your finger
- “Catching “ or locking feeling when you move the finger
- Decreased or limited finger movement
- Pain and tenderness
- A bump or nodule at the base of the finger
- Finger is locked in a bent position
While trigger finger is a common condition, there are several risk factors which may lead you to develop the condition.
What Causes Trigger Finger?
Trigger Finger develops because of prolonged irritation of the tendon. The irritation and swelling prevents the affected tendon from sliding through the tendon sheath properly. This is what causes the pain and stiffness. Eventually the finger becomes permanently stuck, because the tendon cannot move at all.
While there are no definitive causes of trigger finger, there are certain risk factors that can lead to the development of the condition.
- Patients normally develop the condition between the ages of 40 and 60
- Women develop trigger finger more than men
- Health Conditions
- Patients who have pre-existing conditions such as diabetes, rheumatoid arthritis, hypothyroidism, etc. have a greater chance of developing trigger finger.
- Other hand disorders
- Previous diagnosis (such as carpal tunnel syndrome, Dupuytren’s contracture, and De Quervain’s tenosynovitis) are associated with a higher risk of developing trigger finger.
Just because you fit these factors does not mean you will develop trigger finger, it just means you are predisposed and are at greater risk.
Trigger finger is relatively easy to diagnose, and does not require extreme testing as with other conditions. Your doctor won’t even need to give you an x-ray, instead they will do a physical examination where they will look for:
- Tenderness in the tendon sheath, mainly in the palm of the hand
- Thickening or swelling at the base of the fingers or in the palm
- Triggering when you bend or straighten your finger
Based on the severity of your condition, your doctor will help devise a treatment plan to suit your needs.
Your physician will likely recommend nonsurgical treatment options first. These may include:
- Taking breaks and resting the affected hand will go a long way to easing symptoms.
- Wearing a splint
- Splinting your wrist at night may be recommended to keep the affected finger in a straight position.
- Occupational therapy can help stretch and strengthen the affected finger, which will improve overall movement
- Steroid injections
- In more severe cases, corticosteroids may be recommended (preferably under ultrasound guidance). The injections alleviate swelling and inflammation temporarily. If the injection does not improve symptoms, then surgery may be required.
The surgery is called “tenolysis” aka “trigger finger release.” While it is an elective surgery, it may be beneficial based on how much pain, or how little movement you have. It is an outpatient procedure which aims to release the A1 pulley causing the trigger finger.
Endoscopic decompression is Dr. Brutus’s preferred technique. The procedure uses miniaturized instruments and allows targeting just the annular pulley without cutting into the palm. It is performed under local anaesthesia and doesn’t require stitches. It causes less pain, reduces scar sensitivity and shortens recovery.
Even after surgery, some patients may experience ongoing stiffness as they recover. While trigger finger is common, recognizing the early warning signs will be key to delaying deterioration in your hand. With the proper treatment, you should be able to improve your condition in no time.