Trigger Finger: Everything You Need to Know

Stenosing tenosynovitis, which is commonly referred to as trigger finger, refers to a condition characterized by a finger (or a thumb) that remains in a bent or straightened position. The bent position is the most common form of trigger finger, and it can affect multiple fingers.

What Causes Trigger Finger?

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Trigger finger usually occurs due to repetitive movement (e.g., typing), an injury (e.g., forceful use of a digit) or an extremely painful form of inflammatory arthritis (i.e., gout).

Since tendons provide the connection between muscles and bones, as a muscle tightens, the tendon is pulled, which causes the bone to move.

While bending the finger, its tendons slide through a tunnel. This tunnel is referred to as a tendon sheath. If the sheath becomes inflamed, or if the tendon itself has developed a bump, it can no longer slide smoothly through its sheath. This inability of the tendon to slide easily through the tunnel causes the thumb to remain in a bent or a straight position.

Risk Factors of Developing a Trigger Finger

An individual who has an occupation or a hobby that requires prolonged use of the hands or the gripping of items for long periods is at the highest risk of developing a trigger finger.

Some other risk factors include:

• Having diabetes mellitus.
• Being a female.
• Having rheumatoid arthritis.
• Aging.

Recognizing Trigger Finger: The Symptoms

The symptoms associated with trigger finger include stiffness, pain and locking of the digit.

Other symptoms include:

• Tenderness at the base of the digit is a common symptom of trigger finger.
• While flexing or straightening the finger, it may snap.

Until the symptoms associated with trigger finger improve, individuals should not hold any device that vibrates in the hand of the affected finger. Furthermore, never attempt to bend a stiff finger as this can rupture the inner tendon, causing more damage.

Treating Stenosing Tenosynovitis

Splinting

“Trigger Finger Splint” by Ernest Negus CC0 1.0

A mild case of stenosing tenosynovitis may only require splinting the digit for about six weeks to keep it immobile.

Inhibiting the finger’s ability to move prevents aggravation to the affected sheath, which helps reduce inflammation.

Splinting is vital because twisting, straining or bending a stiff finger can increase the damage to the tissue. In addition, it takes longer to heal.

Hot and Cold Therapy

Cold therapy reduces inflammation and heat relaxes the muscles.

Heat therapy should only be implemented 48 hours after the initial onset of the condition. Using heat sooner can increase inflammation, which causes additional damage. As such, cold therapy should be used for the first 48 hours.

Cold Therapy Instructions

Cold therapy can be performed on and off throughout the day. A frozen gel pack works best for this type of therapy. Remember to place some type of cloth between the ice pack and the finger/hand. The ice can remain on the finger and palm for 10 to 15 minutes per session.

Heat Therapy Instructions Using Warm Water

A heat therapy session should last from 10 to 15 minutes. This therapy can be performed every eight hours (after the initial 48 hours have passed). To reduce inflammation even more, add some Epsom salt to the water. Epsom salt reduces inflammation.

Medications

“Tylenol 8-hour Pills Closeup” by Deborah Austin CC by 2.0

Anti-inflammatory medications can also help reduce swelling (e.g., acetaminophen/Tylenol).

Stretching

Stretching the fingers can help relieve the stiffness associated with stenosing tenosynovitis.

The Extensor Stretch

1. Place the hand face down on a solid flat surface.
2. Lift each finger, one at a time, and hold it for a second or two. This stretch should not cause any strain on the finger.
3. Perform this entire exercise 10 times.

A Cortisone Shot

About 50 percent of individuals with trigger finger who choose to have a cortisone shot are cured.

Percutaneous Release

The orthopedic surgeon performs this procedure in the office. He or she numbs the patient’s palm. Then, using a needle, the surgeon carefully moves around the tissue surrounding the affected tendon. This helps release the tendon by breaking apart that which is causing the restriction.

A Surgical Procedure to Address Trigger Finger

If conservative treatment measures fail, a simple surgical procedure involving only a small incision near the base of the affected digit can typically resolve the problem. After creating the incision, the surgeon carefully releases the tendon by cutting open the restricted section of sheath.

If you are in the Pasadena, California, area, and you have trigger finger or any other hand condition, contact Huntington Orthopedics today at 626-486-9494.