Trigger finger or trigger thumb, also known as stenosing tenosynovitis, is a condition where a finger or thumb becomes stuck in a bent position and may snap straight with a popping sensation. It occurs due to inflammation or thickening of the tendons or their protective sheath, which disrupts the smooth gliding motion of the tendon through the sheath. This can lead to pain, stiffness, and even locking of the affected digit in severe cases.
The Symptoms of Trigger Finger
Trigger finger or thumb presents with symptoms that typically worsen over time. These include:
Pain and Tenderness
Pain at the base of the affected finger or thumb, particularly on the palm side, may worsen with movement or pressure.
Stiffness
Difficulty bending or straightening the finger, especially in the morning or after periods of inactivity.
Clicking or Popping Sensation
A snapping or clicking sound when moving the finger is often felt during flexion or extension.
Catching or Locking
The finger may catch, lock in a bent position, or require manual straightening assistance. In severe cases, it may become stuck entirely.
Lump or Nodule
A tender lump may develop at the base of the finger due to the thickening of the tendon sheath.
Worsening Symptoms
Symptoms often intensify after heavy hand use and are more pronounced in the morning or when gripping firmly.
If untreated, these symptoms can progress to permanent stiffness or locking of the affected digit.
What Causes Trigger Finger?
Trigger finger or thumb occurs due to issues with the tendons and their surrounding sheath in the fingers or thumb. Key causes include:
Tendon Inflammation and Thickening
Repeated movement or forceful use of the fingers or thumb can irritate and inflame the tendon, making it harder for the tendon to glide smoothly through its sheath. The inflammation may lead to the formation of a nodule on the tendon, which can catch on the pulley system of the finger, causing stiffness and locking.
Structural Changes in the Pulley System
The pulleys (bands of tissue that hold tendons close to bones) may thicken, narrowing the space for the tendon to pass through. This creates friction and restricts movement.
Repetitive or Prolonged Gripping Activities
Activities such as using power tools, gripping bicycle handlebars, or repetitive hand motions in work or hobbies can increase strain on tendons and contribute to irritation.
Underlying Medical Conditions
Conditions like diabetes, rheumatoid arthritis, and low thyroid function are associated with an increased risk of tendon inflammation and trigger finger.
In most cases, these factors result in a mismatch between the size of the tendon and its sheath, leading to difficulty in smooth tendon movement.
How is it Treated?
Trigger finger can be treated through nonsurgical and surgical methods, depending on the severity of symptoms and how long the condition has persisted.
Nonsurgical Treatments
Rest and Activity Modification
Avoiding repetitive gripping or activities that worsen symptoms can help reduce inflammation.
Splinting
Wearing a splint, especially at night, keeps the affected finger or thumb straight, reducing stiffness and pain.
Medications
Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can relieve pain and inflammation.
Steroid Injections
Corticosteroids are injected into the tendon sheath to reduce swelling and allow smoother movement. This treatment is effective for many patients but may be less so in those with diabetes or rheumatoid arthritis.
Hand Therapy
Occupational therapy, including heat, massage, stretching exercises, and strengthening routines, may improve flexibility and reduce symptoms.
Home Remedies
Applying ice packs for 5–15 minutes several times daily can help manage inflammation.
Surgical Treatments
Open Surgery
A small incision in the palm releases the A1 pulley, allowing the tendon to glide freely. This is a standard outpatient procedure with minimal risks.
Percutaneous Release Surgery
A needle is inserted through the skin to release the pulley without making an incision. This method is less invasive but carries a slightly higher risk of complications due to nearby nerves and arteries.
When Surgery Is Recommended
Surgery is typically advised if nonsurgical treatments fail after 6 months or if the finger becomes permanently locked in a bent position.
Recovery from surgery usually takes a few weeks to months, with gradual improvement in flexibility and function.
Dr Clem Bonney & Trigger Finger
Dr Clem Bonney as an Occupational physician, has years of experience in diagnosing and treating musculoskeletal disorders; Dr. Bonney has become a trusted expert in providing comprehensive care for patients suffering from this common hand condition.
Trigger finger, also known as stenosing tenosynovitis, can cause significant discomfort and limit movement, leading to a reduced quality of life. Dr. Bonney uses a combination of diagnostic techniques, non-surgical treatments like corticosteroid injections and physical therapy, and when necessary, refers to orthopedic specialists with minimally invasive surgical options to restore proper hand function and alleviate pain.
Known for his compassionate approach, Dr. Bonney prioritizes patient education and tailored treatment plans, ensuring that each individual receives the best care for their specific needs. With a passion for helping patients regain their mobility and independence, Dr. Bonney is dedicated to providing lasting solutions for trigger finger and other hand-related conditions.
Dr. Bonney’s holistic and individualized approach to treatment focuses on both immediate relief and long-term recovery, empowering patients to live pain-free and restore functionality to their hands.