TRIGGER FINGER

Trigger finger is a condition in which one of your fingers gets stuck in a bent position. Your finger may bend or straighten with a snap — like a trigger being pulled and released.

Trigger finger is also known as stenosing tenosynovitis. It occurs when inflammation narrows the space within the sheath that surrounds the tendon in the affected finger. If trigger finger is severe, your finger may become locked in a bent position.

Causes:

Most of the time, it comes from a repeated movement or forceful use of your finger or thumb. It can also happen when tendons — tough bands of tissue that connect muscles and bones in your finger or thumb — get inflamed. Together, they and the muscles in your hands and arms bend and straighten your fingers and thumbs.

Risk Factors:

Things that make you more likely to get trigger finger include:

  • Age: It usually shows up between ages 40 and 60.
  • Gender: It’s more common in women than men.
  • Health conditions: Diabetes, gout, and rheumatoid arthritis can cause trigger finger.
  • Job: It’s common among farmers, industrial workers, musicians and anyone else who repeats finger and thumb movements.

Symptoms:

Signs and symptoms of trigger finger may progress from mild to severe and include:

  • Finger stiffness, popping or clicking sensation as you move your finger
  • Tenderness or a bump in the palm at the base of the affected finger
  • Finger catching or locking in a bent position, which suddenly pops straight
  • Finger locked in a bent position, which you are unable to straighten

When to see a doctor:

Seek immediate medical care if your finger joint is hot and inflamed, as these signs may indicate an infection.

If you have any stiffness, catching, numbness or pain in a finger joint, or if you can’t straighten or bend a finger, make an appointment with your doctor.

Diagnosis:

Your doctor will start with a physical exam of your hand and fingers. The finger may be swollen, stiff, and painful. You might have a bump over the joint in the palm of your hand. Or it could be locked in a bent position.

Treatment:

Trigger finger treatment varies depending on its severity and duration.

Medications

Nonsteroidal anti-inflammatory drugs may relieve the pain but are unlikely to relieve the swelling constricting the tendon sheath or trapping the tendon.

Therapy

Conservative noninvasive treatments may include:

  • Rest. Avoid activities that require repetitive gripping, repeated grasping or the prolonged use of vibrating hand-held machinery until your symptoms improve. If you can’t avoid these activities altogether, padded gloves may offer some protection.
  • A splint. Your doctor may have you wear a splint at night to keep the affected finger in an extended position for up to six weeks. The splint helps rest the tendon.
  • Stretching exercises. Your doctor may also suggest gentle exercises to help maintain mobility in your finger.

Surgical and other procedures

If your symptoms are severe or if conservative treatments haven’t helped, your doctor might suggest:

  • Steroid injection. An injection of a steroid medication near or into the tendon sheath may reduce inflammation and allow the tendon to glide freely again. This is the most common treatment.
  • Percutaneous release. After numbing your palm, your doctor inserts a sturdy needle into the tissue around your affected tendon. Moving the needle and your finger helps break apart the constriction that’s blocking the smooth motion of the tendon.
  • Surgery. Working through a small incision near the base of your affected finger, a surgeon can cut open the constricted section of tendon sheath.

Recovery

The choice of treatment also affects recovery. For example, you may need to wear a splint for 6   weeks after the surgical procedure , But most patients with trigger finger recover within a few weeks by resting the finger and using anti-inflammatory drugs without the need of surgery .

Reference:

https://www.webmd.com/rheumatoid-arthritis/guide/trigger-finger#1

https://www.mayoclinic.org/diseases-conditions/trigger-finger/symptoms-causes/syc-20365100

-Dr.ChandraShekar

 

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