Trigger Finger

Overview and Facts about Trigger Finger

Trigger finger occurs when a person’s finger gets stuck in a bent position. In severe cases, the finger can become locked into this position.

With trigger finger, the finger opens or closes with a snap, much like a trigger. Technically called stenosing tenosynovitis, this orthopaedic condition occurs when inflammation leads to a narrowing around the tendons in the finger. It develops most often in women and patients with diabetes.

Signs and Symptoms of Trigger Finger

The signs and symptoms of trigger finger can come and go and range in severity from mild to extreme. The most common symptoms of stenosing tenosynovitis include:

• Stiffness in the finger, especially upon waking up
• Popping and/or clicking sensations with finger movement
• Catching or locking in the finger joints when trying to bend or straighten the finger
• Inability to straighten a locked, bent finger
• A bump or tenderness in the palm at the base of the finger

Trigger finger can develop in any of the fingers or in the thumb. It may affect just one digit or more than one, and it can also occur in one hand or in both.

Causes and Risk Factors of Trigger Finger

Tendons, the fibrous cords that attach muscle to bone, are surrounded by protective tendon sheaths. Trigger finger occurs when the tendon sheath of the finger becomes inflamed. This irritation interferes with how the tendon functions and halts its normal gliding movements.

When the inflammation of the sheath persists, it can lead to scarring, thickening of the sheath, and the formation of bumps that can disrupt the tendon’s movements.

Those with the greatest risk of developing trigger finger include people who:

• Engage in repeated or prolonged gripping
• Have diabetes or rheumatoid arthritis
• Have undergone carpal tunnel surgery
• Are female

Tests and Diagnosis of Trigger Finger

Diagnosis of trigger finger occurs after a physical examination. During the exam, the doctor may open and close the hand, check the motion of the fingers, and observe any locking or jerking in the finger movements. They will also look for nodules or tender spots on the palm.

Treatment and Care for Trigger Finger

The severity of trigger finger symptoms determines the type of treatment. In mild cases, over-the-counter, anti-inflammatory medications can reduce symptoms and improve function of the fingers.

When further treatment is necessary, the doctor may suggest:

• Resting the fingers by avoiding gripping any objects
• Wearing padded gloves
• Wearing a splint at night
• Stretching exercises

In moderate to severe cases, more aggressive treatments may be necessary. The doctor may suggest steroid injections into the tendon sheath. When this doesn’t work, the doctor may perform a percutaneous release procedure. During this treatment, the doctor uses a needle to break apart the constriction interfering with movement.

When these treatments prove ineffective, surgery may be the only option. Through an incision at the base of the finger, the doctor makes a cut along the tendon sheath, reducing any pressure caused by inflammation and eliminating any constriction that binds the tendon.