Trigger finger is a colloquial name for a medical condition that causes a finger to become stuck in a bent position. When this happens, the finger can only straighten with a snap.
The snapping of the finger during release is comparable to the pulling and release of a trigger. This gives the condition this name. The official name for the condition is actually stenosing tenosynovitis. When it affects the thumb, it is known colloquially as “trigger thumb”
Trigger finger is caused by inflammation in the sheath that surrounds the tendon controlling the finger. That inflammation narrows the space in the sheath and makes tendon movement difficult. When the condition is severe, it can cause the finger to be locked in the bent position. The patient then has even greater difficulty trying to straighten the finger.
Trigger finger tends to affect people who work in occupations requiring plenty of gripping movements of the wrist and fingers.
Home based treatment can include use of painkillers or nonsteroidal anti inflammatory drugs (NSAIDs). In addition, resting the affected finger, using a finger splint and special stretching exercises can help. If these fail, doctors may suggest steroid injections and other surgical procedures.
The movement of each finger is controlled by a “flexor” tendon passing through the middle of the finger. The tendons connect to muscles at the base of each finger. Each tendon is encased in a protective sheath.
In a healthy finger, the tendon moves freely up and down the sheath as the finger is straightened or bent.
However, the sheath containing the tendon may become irritated and inflamed. Once this happens, there is less room for the tendon to glide through the middle of the sheath. The finger is then more difficult to bend or straighten and trigger finger develops.
If the condition is not treated, the tendon may develop scars and bumps that impede finger movement even more. These bumps are called nodules.
The irritation and inflammation of the tendon sheath usually happens in response to repetitive finger movements over an extended period. Trigger finger is therefore an example of an overuse or repetitive stress injury (RSI)
As with any RSI, there are a number of factors that may increase the risk of developing the condition. In the case of trigger finger, these are:
Symptoms of trigger finger include the following:
Trigger finger occurs sometimes in more than one finger and may sometimes occur in the thumb.
Trigger finger diagnosis generally requires only a review of the patient’s medical history and a physical exam.
The review of medical history will be to determine whether there are any previous hand or wrist injuries that may be contributing to the problem.
As part of the physical exam the patient may be asked to open and close the hand. The doctor will check for painful areas while this is done.He or she will also check the extent of finger/thumb locking and stiffness.
Another telltale sign of trigger finger that the doctor may look for is a bump on the palm at the base of the affected finger. During movement of the fingers, the doctor will probably check for corresponding bump movement. This would indicate that the bump is actually on the tendon moving the finger – a sign of trigger finger.
As with most RSIs, treatment of trigger finger should start with non-invasive home based methods. Surgery and/or more invasive approaches should be tried only if conservative methods fail.
This stage of the treatment will usually include:
If the above home based treatments do not bring relief, doctors may suggest progressively more invasive options:
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