Trigger finger, also known as stenosing tenosynovitis, occurs due to inflammation of the tendons that flex your fingers, causing finger tenderness and pain. The condition limits finger movement and can make it difficult to straighten or bend your finger.
Trigger finger symptoms
Common early symptoms include:
- Lingering soreness in the base of your thumb or another finger
- A bump or lump around the base of your finger near the palm that can cause pain
- Tenderness around the base of your finger
- Clicking, snapping, or popping noise with movement
- Locking sensation when bending finger or stiffness in your finger
- Pain when you bend your finger
If you don’t get treatment for it, trigger finger can progress. Advanced symptoms include the thumb, another finger (most commonly the ring finger), or both being locked in a bent or straight position. You may also be unable to uncurl your finger without using the other hand if you have an advanced case of trigger finger.
The symptoms of trigger finger tend to be worse in the morning. The finger typically starts to relax and move more easily as the day goes on.
What causes trigger finger?
Your fingers have several small bones. Tendons connect these bones to muscles. When your muscles contract or tighten, your tendons pull on your bones to move your fingers.
Long tendons, called flexor tendons, extend from your forearm to the muscles and bones in your hands. Flexor tendons slide through a flexor tendon sheath, which is like a tunnel for the tendon. If the tunnel narrows, your tendon can’t move easily, which is what occurs in trigger finger.
When the tendon slides through the narrowed sheath, it becomes irritated and swells. Motion becomes extremely difficult. Inflammation may cause a bump to develop, which further restricts movement. This results in your finger staying in a bent position and it becomes extremely difficult to straighten.
Who is at risk for trigger finger?
Trigger finger tends to be more common in women than in men and usually occurs in people between the ages of 40 and 60. Other factors that increase the chances of someone developing trigger finger include:
- Rheumatoid arthritis
- Performing repetitive activities that can strain your hand, such as playing a musical instrument
Based on a study completed by an academic medical institution, trigger finger is more prominent in musicians, farmers and industrial workers.
A physician can usually diagnose trigger finger with an office visit, physical examination of your hand and some simple questions about your medical history. Your doctor will listen to characteristic click upon movement of your fingers and look for a bent finger. They may also watch you opening and closing your hand. Diagnosis of trigger finger will not usually require an x-ray or other imaging tests.
How do you treat trigger finger without surgery?
Treatments depend on the severity of the symptoms but at-home treatments include:
- Rest: Take a break from repetitive activities for four to six weeks.
- Splinting: You may need to wear a brace or splint to restrict motion and rest the hand.
- Heat or ice: Heat or ice can be applied to reduce swelling. Placing your hand in warm water several times throughout the day can also relax the tendons and muscles in your fingers and hand.
- Exercise: Gentle exercises may help decrease stiffness and improve range of motion.
- Medications: Anti-inflammatory drugs (NSAIDs), can help relieve pain and inflammation and include ibuprofen (Advil), naproxen (Aleve) and other prescription anti-inflammatories.
- Steroid injections: Steroid injections may be given to resolve the issue. However, if symptoms do not improve after a second injection, surgery might be the next option.
Trigger finger surgery
If medications and at-home treatments don’t work, your doctor may recommend surgery known as “tenolysis” or “trigger finger release.” Surgeons perform surgery for trigger finger on an outpatient basis such Raleigh Orthopaedic Surgery Center. After an injection of local anesthesia to numb the single area, your surgeon makes a small cut in the palm and then cuts the tightened tendon sheath.
As the tendon sheath heals, the area is looser, helping your finger move more easily. Surgery risks include infection or ineffective surgical results.
Recovery from trigger finger surgery
Surgery recovery can take a few weeks to six months. Your doctor may recommend physical therapy exercises to relieve post-surgery stiffness. As a general rule, once the doctor releases the tendon sheath, the tendon can move freely.
You should be able to return to your normal activities within a few days after surgery. Your doctor will remove the sutures in 7 to 14 days.
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