What is Trigger Finger?
Trigger finger is more than a little stiffness and pain in a finger. It is an orthopedic condition, known as stenosing tenosynovitis, that can keep a person from having full use of their ring finger, thumb, or other fingers. The symptoms of trigger finger originate in the tendon sheath of a finger. The tendon sheath is a tunnel through which a flexor tendon passes. Each flexor tendon has its own sheath in the palm of the hand and each finger that enables it to glide smoothly.
Along each tendon sheath are bands of tissue called pulleys. These secure the flexor tendons near the bones in the fingers. In trigger finger, it is most commonly the pulley at the base of the affected finger that causes issues for range of motion. This pulley becomes inflamed or thickened, which diminishes the glide of the flexor tendon as the finger bends and straightens.
Is it Painful?
It can be. The inflammation at the base of the finger can create soreness or tenderness when the area is pressed. The finger is usually especially stiff and sore in the mornings and after other periods of non-use.
How is Trigger Finger diagnosed?
An orthopedic doctor can diagnose trigger finger by consulting with the patient about their symptoms and by looking at the hand. It is usually unnecessary to perform imaging like x-rays or other tests. During the exam of the finger, the doctor looks for indications of trigger as:
- Tenderness in the palm of the hand near the flexor tendon sheath
- Swelling or thickening of the tendon sheath
- Catching, popping, or sticking when the finger is bent and straightened
What Are the Trigger Finger Treatment Options?
There is a possibility that the trigger finger may resolve with proper nonsurgical care. If symptoms are new, a doctor may recommend steps to minimize inflammation and maximize flexibility. Recommendations may include:
- Rest and avoidance of activities that worsen symptoms.
- Over-the-counter pain relievers or nonsteroidal anti-inflammatory medication.
- Splinting of the finger at night to maintain a straight position.
- Exercises that gently stretch the finger and improve range of motion.
For more severe symptoms, a doctor may administer a steroid injection into the tendon sheath to quickly reduce inflammation. This treatment may improve comfort and mobility in a few days to a few weeks. Sometimes, a second injection is needed and, if symptoms do not improve, surgery may be considered.
How can I Prepare For Trigger Finger Treatment?
Nothing has been proven to prevent this condition, but if you can minimize certain stresses placed on your wrists and hands, it can limit the opportunities for inflammation of the ligaments that then compress the median nerve.
- Take breaks — Take breaks to bend your hands and wrists. Gently stretch them. Alternate tasks, if possible.
- Reduce your grip — Hit the keys on the keyboard softly. Use a larger pen for prolonged handwriting.
- Use Good Form — Keep your keyboard at elbow height or slightly lower. Avoiding bending your wrist to full extension.
- Change your mouse — Get an ergonomic mouse that doesn’t strain your wrist.
- Keep your hands warm — Working in a cold environment makes it more likely you’ll develop hand pain and stiffness. If you need to, wear fingerless gloves that keep your hands and wrists warm.
How is The Trigger Finger Treatment Performed?
Surgical treatment to release the trigger finger is called tenolysis. This outpatient procedure is performed to release the pulley that is preventing the tendon from moving smoothly through the tendon sheath. Tenolysis is performed with a local anesthetic that numbs the base of the finger. Once the tissue is numb, the doctor either inserts a small needle into the sheath or makes a tiny incision. They then divide, or release, the pulley so the tendon can move freely.
What Can I Expect From My Results?
Patients who undergo trigger finger release are advised to move their finger right away after surgery. The palm may feel sore and may become slightly swollen. However, these effects should not make finger movement intolerable. When possible, patients can elevate their hand over their heart to help reduce swelling.