Stenosing tenosynovitis, commonly known as trigger finger, is a condition where a finger or thumb catches or locks when trying to straighten it. This occurs because the flexor tendon cannot glide smoothly within its protective tunnel. For many people, adopting a conservative treatment approach, which includes specific exercises, is often the first and most effective step in managing symptoms. These targeted movements help restore smooth tendon function and prevent stiffness.
Understanding Trigger Finger
Trigger finger results from an imbalance between the size of the flexor tendon and the opening of the tendon sheath, often at the A1 pulley located near the palm. The flexor tendon normally slides easily through this fibrous pulley system when the finger bends and straightens. However, repeated forceful gripping or irritation can cause the tendon or the surrounding sheath to swell or thicken.
This thickening creates a size mismatch, causing the tendon to catch or “pop” as an inflamed area forces its way through the narrowed pulley opening. Risk factors include repetitive hand movements, especially those involving heavy gripping or grasping. Underlying health conditions, such as diabetes, rheumatoid arthritis, and gout, also increase susceptibility to the condition.
Specific Hand and Finger Exercises
The goal of exercises for trigger finger is to promote smooth tendon gliding and maintain the finger’s full range of motion without causing pain. These movements should be performed gently, focusing on mobility rather than strength. Consistency is beneficial, and exercises can be done several times throughout the day for short durations.
Tendon gliding exercises are especially helpful for encouraging the tendon to move freely through the pulley system. Start with the fingers straight, then slowly move through a sequence: first into a hook fist, then into a full fist, and finally back to a straight hand. Repeat this sequence 10 times, ensuring the motion remains fluid and pain-free.
The fingertip block exercise isolates the movement of the smaller joints. Place the palm face up and use the opposite hand to hold the affected finger just below the middle joint. Gently bend the fingertip down toward the palm, holding the stretch for a few seconds before straightening it. This helps maintain flexibility in the distal joint, which is often affected by stiffness.
A gentle palm stretch can also relieve tension in the hand and forearm muscles. Lay the affected hand flat on a table, palm facing down, and use the other hand to gently lift each finger one at a time, stretching it upward. Hold this passive stretch for about 15 seconds per finger, repeating the process two to three times daily. This aims to keep the tendon mobile and reduce the likelihood of catching.
Complementary Non-Exercise Treatments
Conservative management often combines exercises with other strategies to reduce inflammation and allow the tendon to rest. Activity modification is a foundational step, requiring you to identify and avoid the repetitive, forceful gripping actions that aggravate the condition. This temporary reduction in strain allows the inflamed tissues an opportunity to heal.
Wearing a splint, particularly a small finger splint worn at night, can be an effective way to keep the affected finger straight while sleeping. This position prevents the finger from curling into a fist, reducing morning stiffness and locking. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can manage pain and decrease overall inflammation.
Applying heat or ice can provide temporary relief from symptoms, depending on what feels better for the individual. Heat, such as a warm compress or soaking the hand in warm water for 5 to 10 minutes, can help loosen the tissues and prepare the hand for exercises. Conversely, ice application can help reduce acute swelling and pain following activity or if the finger feels inflamed. Gentle massage at the base of the affected finger near the nodule may also help to soften the thickened tissue.
When to Seek Professional Medical Care
While many people find relief with exercises and home care, professional medical evaluation is sometimes necessary. Seek care if the pain is severe or unremitting, or if the finger locks completely and cannot be straightened without manually forcing it. Persistent clicking or popping that does not improve after several weeks of consistent conservative treatment indicates the condition may be progressing.
A primary care provider, hand specialist, or occupational therapist can offer advanced treatment options. They may recommend a corticosteroid injection directly into the tendon sheath at the base of the finger, which is effective in reducing inflammation. If non-surgical treatments fail to provide lasting relief after several months, a surgical release may be discussed. This typically involves a minor outpatient procedure to cut the constricted portion of the pulley system, allowing the tendon to glide freely again.