- advancedorthopedics
Trigger Finger
While the name might conjure images of wild west sharpshooters or deadly snipers, the condition of “trigger finger” gets its name from the trigger-like snap that occurs when the finger suddenly releases after a period of being locked down in a bent position.
What is Trigger Finger?
The tendons that run into the fingers have protective sheaths around them. These “tendon shealths” can become irritated and inflamed and can make it difficult for the tendon to glide through the sheath when we close and open our hands. Patients with trigger finger will report finger stiffness, a popping or clicking sensation when moving the finger, finger locking in a bent position and tenderness or a bump at the base of the finger. In severe cases, the finger may become locked in the bent position and the patient may be unable to straighten it at all.
Causes and Risk Factors
Prolonged irritation of the tendon sheath can produce scarring, thickening, and the formation of nodules that impede the tendon’s motion. “Trigger finger” is caused by a thickening of the tendon, or development of a nodule that results in catching under the pulley at the base of each finger. This condition can make daily activities challenging and painful to complete. Understanding who is at risk, and activities that may exacerbate these muscles is important! Common activities that may exacerbate the condition include:
Heavy work with hands (i.e. tool use, vibrating equipment, frequent loading or carrying objects)
Rock climbing
Throwing sports
Prolonged and repetitive gripping and carrying
Awkward finger positioning
Women and older adults, as well as people with diabetes, rheumatoid arthritis, carpal tunnel syndrome, and congestive heart failure are at higher risk of developing this condition.
Treatment of Trigger Finger
There are a few options for addressing a painful trigger finger. First, conservative methods will be used. These include:
Rest
Medication
Steroid injections
Nighttime orthotics
Activity modifications
Patients may be fit with a splint (orthosis) which may be kept on from 2-6 weeks to allow for the inflammation to resolve and the tissue to heal. Patients will also be asked to avoid pain-causing activities and may desire to take anti-inflammatory medication. The last line of nonsurgical treatment is steroid injections, which may be administered up to two times to reduce inflammation and pain. If non-surgical approaches fail, surgery is often the next recommended step. This is especially indicated if the finger is stuck in a bent position, as surgery may be needed to prevent permanent stiffness. In general, the surgery involves the following: a small incision is made in the palm and the tendon sheath tunnel is cut to allow the tendon to glide. After surgery, your hand surgeon may recommend occupational therapy or hand therapy for scar massage and to provide safe exercises to increase strength, range of motion and reduce pain.
How Can Occupational Therapy Help?
This conditon responds best to non-surgical treatment when addressed quickly from the time of onset. If you are experiencing symptoms similar to what is described above, contact our office to set up a free screen. During a screen you will have the opportunity to discuss your questions and concerns with our therapists. Here at Advanced Orthopedic we want to help you on your road to recovery so that you can return to all your normal activities!
References
Mayo Clinic Staff. (2014). Diseases and conditions: Trigger finger. Mayo Clinic. Retrieve from http://www.mayoclinic.org/diseases-conditions/trigger-finger/basics/definition/con Jennings, C. D. (2010). Trigger Finger. OrthoInfo. Retrieved from http://orthoinfo.aaos.org/topic.cfm?topic=a00024.