Causes and Treatment of Common Hand Problems: Trigger Finger
What is a trigger finger?
Before talking about cause and symptoms, we would like to define the disease. Trigger finger is an excruciating condition that entirely affects your thumb and fingers, they get locked while you bend them individually or both. Trigger finger can take place any time with any finger or more than single finger at an instance, even it can affect both of your hands. Trigger thumb is quite similar to tenosynovitis. When stenosing affects particularly your thumb, it is known as trigger thumb which is very painful as well.
Let’s talk about the hand anatomy so that you can understand better:
In our hand’s flexor tendons are threadlike structures associated with forearm muscles and bone of the fingers. When these forearm muscles contract, the flexor muscle stimulates our fingers to bend. In the human body each flexor tendon goes through a tunnel like structure of the palm, and fingers which makes the bending process very smooth as well. The tunnel-like structure is known as “tendon sheath”. The tendon sheath is attached with a layer of band tissue which is known as “pulleys” that holds the flexor tendons very closely to finger bones. These tendons go through the tissue bands or pulleys when we move our finger. The first pulley remaining at the base of the finger is called the “A1 pulley” which is primarily involved in the trigger finger.
What happens when trigger finger takes place
When patients suffer from trigger finger, The A1 pulley gets injured or thickened or inflamed which makes it difficult to glide flexor muscles which are responsible for finger bending. After some time, the flexor tendon also gets inflamed and develops nodules on its upper surface. When a patient’s finger bends, the flexor muscles along with the nodule go through the pulley, and the patient experiences a painful sensation.
In a very serious case of trigger finger, the particular finger gets locked and stuck in a bent condition, then the patient has to use his other hand to make the bent finger straight.
At the time of diagnosis, your orthopaedic surgeon will check the stiffness of your finger and the condition of locking.
Common cause of trigger finger:
Tendons are a band of tissues that connect muscles and bones. On the hand, muscles and tendons need to cooperate to flex and stretch your fingers as well as your thumb. In general tendons slide easily through a narrow tunnel of tissue, referred to as sheath. When trigger fingers or trigger thumb tendons become inflamed and swelling (inflamed) and can no longer slide into their sheaths. The formation of a bump (nodule) can also develop within the tendon making it more difficult for the tendon to slide across its sheath.
Trigger finger symptoms:
Some basic symptoms of trigger fingers are mentioned below. However, symptoms differ patient to patient.
- When patients straighten or bend their fingers, they experience excruciating pain. It becomes worse while they remain in a sedentary state, pain alleviates when they start to move.
- At morning, after getting out of bed, feeling of stiffness is more with pain and enough discomfort
- Few patient notice soreness, inflammation, or small bump at the base of the thumb or other four fingers, orthopaedic surgeon calls it nodule
- Patients also experience a popping feeling while they bend their finger as well
- Most prominent symptom is a sudden locked finger which can’t be straightened by itself.
At early stage symptoms are very mild, if it remains untreated it can become worse over time. However, threatening fingers become worse in the morning, or when patients hold something firmly, or try to straighten their fingers.
Available treatment options of trigger fingers:
Appropriate rest of hand: If you’re suffering from an initial level of trigger finger, try to avoid frequent movement of thumb and fingers. You need to take a break from the hand engaging activity which may aggravate the condition. If you are unable to avoid it, use medicated padded gloves recommended by a physiotherapist.
Splints: Your orthopaedic consultant will give you splints specially designed for your trigger fingers to keep it still as much as possible.
Do some stretching exercise: A gentle hand movement and finger stretching exercise warm-up your finger and reduce stiffness of fingers and increase range of motion.
NSAIDs: if pain is unbearable while hand movement, your consultant may prescribe you some over-the counter pain-killer drugs like ibuprofen and naproxen; However, taking pain killers excessively is not good for your health. To avoid the side effects of NSAIDs, doctors also recommend steroid injection into the tendon sheath.
Surgery: It is the last and final option for trigger finger. If each of the above treatments don’t work; your orthopaedic surgeon prescribes you surgery. There are two kinds of surgery available for trigger finger. One is percutaneous release another is tenolysis or trigger finger release surgery.
The surgery recovery time depends on the condition you had. To speed up the healing process, doctors often recommend hand therapy during the rehabilitation period.