Trigger finger, medically known as stenosing tenosynovitis, is a condition that affects the tendons responsible for bending your fingers and thumb. It causes a digit to get stuck or “lock” in a bent position, then suddenly snap straight. This ailment causes discomfort and interferes with daily activities.
Understanding Trigger Finger
Trigger finger involves the hand’s tendons, tendon sheaths, and pulleys. Tendons connect muscles to bones for movement. Flexor tendons run along the palm, encased in protective tendon sheaths providing smooth gliding. Pulleys are thick tissue bands forming arches over tendons, holding them close to finger bones.
Trigger finger occurs when the flexor tendon or its sheath inflames or thickens, forming a lump on the tendon or thickening the pulley. When the finger bends, this enlarged tendon or nodule struggles to glide through the narrowed pulley, causing it to catch. Symptoms include clicking, popping, or catching when moving the finger, stiffness, and pain at the base of the finger or thumb, especially when gripping. In severe cases, the finger may lock, sometimes requiring the other hand to straighten it.
Repetitive gripping or grasping, common in farming, gardening, or industrial work, contributes to trigger finger. It is also more common in individuals with health conditions like diabetes, rheumatoid arthritis, gout, and an underactive thyroid. Women and those over 40 are also at higher risk.
Self-Care Strategies
Self-care for trigger finger aims to reduce inflammation and improve tendon mobility. Resting the hand by avoiding aggravating activities allows tendons to heal. Modifying tasks to reduce repetitive gripping or forceful movements helps.
Splinting, especially at night, keeps the finger or thumb extended. This prevents curling during sleep, reducing stiffness and irritation, allowing the tendon to rest. Splints are worn for weeks for gradual improvement.
Cold therapy, like an ice pack, reduces inflammation, especially during initial pain. After 48 hours, or if locking is prominent, warm soaks or heat therapy relaxes muscles, improves circulation, and increases flexibility. Soaking the hand in warm water for 5-10 minutes helps tissues relax before gentle movements.
Gentle exercises maintain flexibility and prevent stiffness. Tendon gliding exercises (straight hand, hook fist, full fist, table top, straight fist) encourage smooth tendon movement. Finger lifts (placing hand flat, gently lifting each finger) improve range of motion. Strengthening exercises (squeezing soft ball, using rubber band to spread fingers) support hand muscles.
Gentle massage at the base of the affected finger or palm alleviates stiffness and improves blood flow. Circular motions at the affected knuckle and along the tendon are beneficial. Over-the-counter NSAIDs, like ibuprofen or naproxen, manage pain and reduce inflammation. Consistent application of these strategies is key to relief.
Medical Interventions
If self-care strategies fail or symptoms worsen, medical attention is necessary. Seek a doctor for persistent pain, increased locking, inability to straighten the finger, or significant daily interference. A healthcare provider can diagnose and recommend treatments.
Corticosteroid injections are a common non-surgical treatment. A corticosteroid, often cortisone, is injected into the tendon sheath at the base of the affected finger. This medication reduces inflammation and swelling around the tendon, allowing it to glide freely through the pulley system. While effective for many, especially for the thumb, success rates vary (66-90%). Effectiveness may be lower in individuals with underlying conditions like diabetes or rheumatoid arthritis.
Physical therapy, especially hand therapy, can be prescribed. A hand therapist provides exercises to improve range of motion, strengthen hand muscles, and educate on activity modifications. These therapies restore function and flexibility to the affected finger.
Surgical intervention, known as trigger finger release or tenolysis, is a last resort when non-surgical treatments fail. This outpatient procedure involves a small incision near the base of the affected finger to cut open the narrowed A1 pulley. Widening this pathway allows the tendon to move without catching or locking, providing permanent relief in most cases.
Preventing Recurrence
Preventing trigger finger recurrence involves ergonomic adjustments and mindful hand care. Modifying workspaces and tools to reduce repetitive gripping or sustained palm pressure is important. Using ergonomic tools with cushioned or larger handles minimizes strain on fingers and tendons.
Taking regular breaks during repetitive hand movements is beneficial. During breaks, gently stretching and resting hands alleviates tension and reduces stress on tendons. Maintaining proper hand and wrist posture, striving for neutral positions, also reduces strain.
Managing underlying health conditions like diabetes or rheumatoid arthritis is important for long-term prevention. Controlling these conditions reduces inflammation and the likelihood of tendon issues. Continuing hand exercises that maintain strength and flexibility, even after symptoms resolve, keeps tendons and surrounding tissues healthy and mobile.