Dr. Carlos Rebollón

Trigger Finger and its Treatment

Trigger finger is a condition that causes the finger to become locked in a flexed position, resulting in pain in the base of the finger and the palm of the hand. Sometimes, a person may feel a strong snap when bending and straightening the fingers, which is similar to the action of a trigger being pulled.

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WHAT IS TRIGGER FINGER SYNDROME?

Trigger finger, also known as stenosing tenosynovitis, spring finger, or trigger thumb, is an inflammatory disorder of the tendon sheath that covers the affected finger’s flexor tendon. Normally, the tendon has smooth gliding movements inside and outside the sheath when the finger is extended and flexed.

When the flexor tendon becomes inflamed, it becomes more difficult to move the finger, and the tendon often loses the ability to perform flexion and extension movements optimally, leading to it getting stuck for a period and then releasing at any moment.

Trigger finger syndrome is more common in people with diabetes and rheumatoid arthritis. However, it can also occur in individuals with manual labor jobs that involve repetitive gripping of an instrument, such as gardeners who frequently use pruning shears.

SYMPTOMS OF TRIGGER FINGER SYNDROME

The initial signs of trigger finger are almost imperceptible. However, as the condition progresses, the symptoms become more severe. These symptoms include:

Stiffness in flexing the fingers, especially in the morning upon waking up.

Hand stiffness.

Audible sounds (snapping and popping) when moving the affected finger.

Sensitivity in the palm of the hand.

Palpable nodule at the base of the painful finger.

Locking of the affected finger and sudden jerking with snapping.

Finger completely locked in flexion with inability to straighten it.

This condition can occur in any finger, including the thumb. While usually only one finger is affected, there is also the possibility of the problem developing in multiple fingers simultaneously.

TREATMENT OF TRIGGER FINGER

After diagnosis, the specialist will recommend various treatment options for trigger finger based on the severity of the condition. These may include:

Medications

Non-steroidal anti-inflammatory drugs (NSAIDs) are generally advised to reduce pain. However, this is not a long-term solution as they are unlikely to reduce the inflammation of the tendon sheath that is blocking the flexor tendon.

THERAPY AS PART OF TRIGGER FINGER TREATMENT

Stopping activities that involve repetitive gripping with the hand, using a splint for a few weeks to allow the tendon to rest, and controlled mobility exercises are part of the initial treatment to correct trigger finger.

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OTHER MINIMALLY INVASIVE PROCEDURES

When trigger finger symptoms continue to worsen despite following the initial treatment guidelines, the specialist may suggest more aggressive techniques, such as:

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STEROID INJECTIONS

Injecting steroids around or directly into the tendon sheath is very useful in reducing swelling and facilitating smooth tendon gliding. This option is one of the most commonly used treatments for trigger finger, with prolonged effectiveness for over a year.

PERCUTANEOUS RELEASE

This procedure involves using local anesthetics to numb the hand. Afterward, the doctor carefully inserts a needle into the tissues near the flexor tendon to perform strategic movements that allow for the release of compression and restoration of fluid to the tendon.

TRIGGER FINGER SURGERY

In this procedure, a small incision is made in the palm of the hand to expose the tendon sheath and release the compressed nodule with a small cut.

PHYSIOTHERAPY TREATMENT FOR TRIGGER FINGER

Physiotherapy is known for providing solutions to various conditions. Here are some physiotherapeutic options for the treatment of trigger finger:

Percutaneous Therapeutic Electrolysis (EPTE).

Deep tissue massages.

Special finger stretching techniques.

Finger extension exercises.

Orthopedic manual therapy.

DIAGNOSIS AND CAUSES OF TRIGGER FINGER

For diagnosis, the specialist gathers the necessary information to create the patient’s medical history. Subsequently, they evaluate the functions of the hand through a physical examination.

During this examination, the doctor will request the performance of various hand and finger movements to check for points of pain, the presence of swelling or nodules, the level of flexibility in flexion and extension movements, and finally, the symptoms of locking.

Trigger finger is usually triggered by:

Jobs, occupations, and hobbies that involve repeated gripping of an instrument or constant use of the hands.

Previous health problems (diabetes and rheumatoid arthritis).

Complications from a previous surgical procedure on the hands or wrists, such as surgery to correct carpal tunnel syndrome.

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FREQUENTLY ASKED QUESTIONS - TRIGGER FINGER SYNDROME

In this section, we provide brief and concise answers to the main questions from our readers…

Trigger finger is a painful condition caused by inflammation of the tendon. As explained earlier, the patient may experience pain in the base of the affected finger and also feel it radiating to the palm of the hand.

Most patients with this condition tend to improve with conventional treatments. If, after exhausting all non-surgical options, the condition continues to not improve, the doctor will most likely recommend surgery.

This surgery has a very low level of complexity, so it usually takes no more than 30 minutes in total. Patients usually achieve very satisfactory long-term results.

Considering that around 90% of cases improve with initial treatment, temporary disability due to trigger finger can last for a maximum of a couple of days during the corticosteroid infiltration into the tendon sheath.

Individuals who have undergone surgery should wait between 3 and 4 weeks before returning to manual work (with prior medical consent). During this time, the wound heals, and the tendon gradually reduces inflammation to achieve optimal and pain-free functioning.

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