Trigger finger is a common medical condition affecting the tendons responsible for finger movement.
This condition causes a constriction or restriction in the movement of the finger, leading to difficulty in extending or flexing it normally.
Consequently, this results in pain and discomfort, significantly impacting daily activities.
In this article, Dr. Yousef Sarhan, Consultant in Physical Medicine and Rehabilitation and Consultant in Orthopedic Surgery and Joints, provides essential information about trigger finger, including its causes, symptoms, and treatment options.
What is Trigger Finger?
Trigger finger, is a condition that occurs when a finger experiences difficulty sliding smoothly during movement.
This disorder causes the tendons responsible for finger movement to become constricted, leading to difficulty in extending or flexing the finger normally.
The issue arises due to inflammation of the tendons or narrowing of the tunnel through which they pass, causing the finger to get stuck or catch in a specific position. This may result in the finger “locking” or making a clicking sound when attempting to move it.
As a result, this condition can be accompanied by pain and stiffness in the finger, affecting the ability to perform simple daily activities.
Causes of Trigger Finger
Trigger finger can occur due to several factors that lead to tendon inflammation and narrowing of the tunnel through which they pass.
The primary causes include:
Injuries or Trauma
Direct injuries or trauma to the fingers, such as strong impacts or accidents, can damage the tissues surrounding the tendons.
This damage may result in tendon inflammation or structural changes in the canal, leading to restricted or disturbed tendon movement and increasing the likelihood of developing trigger finger.
Chronic Medical Conditions
Individuals with certain health conditions may be at higher risk for developing trigger finger. These conditions include:
- Gout.
- Diabetes.
- Osteoarthritis.
- Rheumatoid arthritis.
Genetic Factors
Some individuals may have a genetic predisposition that makes them more susceptible to developing this condition.
Repetitive and Strenuous Activities
Activities that involve repetitive finger movements, such as typing or extensive use of tools, can increase the risk of trigger finger.
Symptoms of Trigger Finger
Symptoms indicative of trigger finger include:
- Difficulty Moving the Finger: The affected individual experiences difficulty extending or flexing the finger normally, often feeling a temporary “locking” or catching during movement.
- Pain at the Base of the Finger: Pain is felt at the base of the affected finger, especially when pressing on it or attempting to move it.
- Swelling or Nodule Formation: A swelling or small nodule may appear under the skin at the base of the finger, resulting from tendon or sheath enlargement.
- Clicking or Popping Sound: A clicking or “popping” sound occurs when attempting to move the finger, particularly when transitioning from a flexed to an extended position.
- Finger Stiffness: In advanced cases, the finger may become stiff in a flexed or extended position, making it difficult to move without medical intervention.
Diagnosis of Trigger Finger
The diagnosis of trigger finger typically involves the following steps:
Medical History Review
The physician inquires about the patient’s symptoms, their onset, and factors that exacerbate the condition.
Doctors gather a comprehensive medical history, including details about underlying health conditions like diabetes or arthritis that may increase the risk of trigger finger.
Clinical Examination
The physician examines the affected hand and fingers, and asks the patient to move their fingers to assess the range of motion.
The doctor may observe any signs of “locking” of the finger or difficulty in movement and may palpate for any nodules or swelling at the base of the finger.
Movement Testing
The physician requests the patient to actively move the affected finger, which helps determine the extent of movement difficulty and reveals any clicking or popping sounds.
X-ray Imaging (in some cases)
Although X-ray imaging is not necessary for diagnosing trigger finger, it may be requested in some cases to rule out other conditions such as bone fractures or arthritis.
How is Trigger Finger Treated?
Trigger finger can be treated using various methods depending on the severity of the condition.
Here are some possible treatments:
Rest and Avoidance of Triggering Activities
It is recommended to avoid activities that place additional stress on the affected tendons and to take breaks from tasks or hobbies that may have contributed to the development of trigger finger.
Splinting
Doctors use splints to keep the affected finger straight. This approach prevents sudden locking and allows the tendon to heal more effectively.
Splints are typically worn at night and may be used for several weeks depending on the severity of the condition.
They help reduce inflammation and prevent repetitive movements that cause finger locking.
Medications
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can be used to reduce pain and swelling.
Doctors may administer corticosteroid injections to reduce inflammation around the affected tendon. This treatment can effectively improve movement and relieve symptoms.
Physical Therapy
Physical therapy is an essential part of the treatment plan for trigger finger, aiming to restore finger function, reduce pain, and help return to normal daily activities. It may include:
- Hand Exercises: Exercises to strengthen the muscles around the affected tendon and improve its flexibility.
These include stretching, pressing, and elongation exercises to enhance the range of motion and reduce stiffness.
The therapy may also include exercises to strengthen the entire hand to support the trigger finger and prevent recurrence.
- Heat Therapy: Heat is used to alleviate pain and swelling in the inflamed tendon area. Heat therapy helps dilate blood vessels and increase blood flow, promoting healing and relaxing the muscles around the tendon.
To improve comfort and reduce symptoms, you can use warm compresses or take warm baths.
- Other Techniques: Physical therapy may also involve gentle massage to improve blood flow and reduce tension in the tissues, as well as the use of supports or splints to stabilize the finger and limit movement in certain cases.
Surgical Procedures for Trigger finger
When non-surgical treatments fail to improve the condition, the doctor may recommend surgical options:
Tendon Release Surgery
If non-surgical treatments fail, the surgeon may perform surgery to release the tendon.
The surgeon makes an incision in the sheath surrounding the affected tendon, allowing the trapped tendon to move freely.
This procedure aims to remove obstacles preventing natural finger movement and help alleviate symptoms and restore finger function.
Endoscopic Surgery
Endoscopic surgery is a precise method for treating trigger finger, involving a small incision near the affected area to insert an endoscope and access the tendon sheath to release it, allowing it to move freely.
Open Surgery for Trigger finger
During open surgery, the surgeon directly accesses and releases the affected tendon.
This procedure is effective and has high success rates when performed by a skilled surgeon.
Post-Surgical Rehabilitation
After surgery, physical therapy plays a crucial role. It includes specialized exercises designed to restore natural movement and strengthen the surrounding muscles. Additionally, the therapy involves techniques to improve tendon flexibility. Consequently, these combined approaches enhance recovery and functionality.
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Sources:
- Professional, C. C. M. (n.d.-d). Trigger finger. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/7080-
- Trigger finger – Symptoms and causes – Mayo Clinic. (2022, December 3). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/symptoms-causes/syc
- Trigger Finger – Trigger Thumb – OrthoInfo – AAOS. (n.d.). https://orthoinfo.aaos.org/en/diseases–conditions/