What is Trigger Finger?
Tendons attach the bones in the hand to muscles in the forearm, allowing motion. The flexor tendons are located on the palmar surface of the hand. As the fingers bend into a fist these tendons glide thru tunnels called tendon sheaths that act to keep the tendons in proper position against the bones. Inflammation can cause the flexor tendon to thicken forming nodules which make it difficult to pass thru the sheath. The tendon sheath may also thicken, narrowing the passageway. Trigger Finger, or Flexor Tenosynovitis, occurs when the flexor tendon gets stuck in a bent position as the digit is being straightened. The digit may then “pop” straight with effort. This can happen in any of the four fingers or the thumb.
What causes Trigger Finger?
While the exact cause is unknown, several factors and activities have been associated with an increased likelihood of developing Trigger Finger. Some risk factors include female gender, middle age, and diabetes. Overuse or repetitive motion injuries, and inflammatory diseases, such as Rheumatoid Arthritis and gout, can also lead to this condition. Anything that produces prolonged inflammation of the flexor tendon, the tendon sheath, or both can result in Trigger Finger.
What are the symptoms of Trigger Finger?
The most prominent symptom is the motion of the finger as it is bent or straightened. The digit may “stick” as it is being bent and then “snap” closed. This can also happen as the finger is being extended. There may be pain or swelling of the finger and sometimes a lump can be felt on the palmar surface near a joint. The stiffness may be worse in the mornings or after periods of inactivity. In severe cases the digit may need manual assistance to fully flex or extend. Occasionally the digit becomes “locked” in either the bent or straight position.
How is Trigger Finger diagnosed?
Diagnosis is based on a complete medical history, review of symptoms, and physical examination. In general, no other testing is required.
How is Trigger Finger treated?
Mild or moderate cases of Trigger Finger usually respond well to conservative treatment. Resting the digit may be all that is needed. The finger may be immobilized in a neutral position with the aid of a splint. NSAIDs (non-steroidal anti-inflammatory drugs) like Ibuprofen may prove useful to ease pain. In moderate cases a corticosteroid injection may be administered to reduce inflammation.
In severe cases of Trigger Finger or those that do not respond to conservative treatment, surgery may be required. Trigger Finger Release Surgery is a quick outpatient procedure that can provide complete relief of symptoms. A small incision is made in the palm, the sheath is opened in the palm and the wound is sutured closed. A bandaid type dressing is left in place for about 10 days. The sutures are then removed and full recovery can be expected within six weeks. During the recovery period there may be some mild tenderness at the incision site and activity is as tolerated. Hand therapy helps to strengthen, increase flexibility and reduce stiffness.
How can Dr. Knight help you with trigger finger?
If you think you have symptoms of trigger finger, a visit to a hand surgeon is recommended. Dr. Knight will expedite your care by making an accurate diagnosis and providing quality and effective care through conservative measures with surgery as a last resort.
Note: The following video contains graphic images.
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