Trigger finger is a condition where one of the fingers gets stuck in a bent position. The finger may bend or straighten with a snap, like a trigger being pulled and released. In medical terms, it is called Stenosing tenosynovitis, one of the most common types of tendon problems like – tennis elbow (lateral epicondylitis), golfers or baseball elbow (medial epicondylitis), biceps tendonitis and Dequervains. Tendons are fibrous cords that attach muscle to bone. They are found throughout the body at each end of a muscle. Each tendon is surrounded by a protective sheath which helps in the movement of tendon.
Who are more likely to develop trigger finger?
People whose work, occupation or simple hobbies involve repetitive hand use and prolonged gripping come under the risk of developing bent finger. Those who have diabetes or rheumatoid arthritis too are at higher risk of developing it. The patients who have gone through Carpel tunnel syndrome surgery too feel its symptoms. Gender wise it is more common in women. The older you are, higher is the risk trigger finger.
The major causes of the trigger finger pain are overuse, strain, injury or too much exercise. It occurs when the sheath becomes irritated or inflamed even if the tendon is in a good shape. This deformation narrows the space within the sheath that surrounds the tendon in the affected finger. This affects in turn the normal gliding motion of the tendon through normal sheath.
The symptoms of the trigger finger vary from mild to severe depending upon the internal imbalance between the tendon and the sheath.
- The patient may complain of finger stiffness, especially in the morning, a popping sensation while moving the finger.
- Tenderness or a bump in the palm can be observed at the base of affected finger.
- Finger locked in a bent position which suddenly turns straight or in some cases gets locked in a bent position unable to be straightened
- Swollen fingers, cracking or snapping sound/ feeling while bending the finger.
The treatment of trigger finger too varies depending on the severity. The doctors, physicians and internists too can diagnose a trigger finger, though in most cases an X-ray or MRI report is needed for confirmation.
- If the pain is mild in the bent finger, try to avoid its movement. Tape the injured finger to the healthy one next to it to provide stability and limit its use. Resting it and icing will allow it to heal within 2 weeks.
- The quickest treatment is a local cortisone injection into the tendon sheath around the affected tendon. Trigger finger can recur after sometime period of normal functioning, so if it persists even after 2 steroid injections and is not responding to it and rest of the above non surgical treatments, then a proper surgery is next step. However it is curable without surgery in most of the cases.
Specialists will be required at this stage, like orthopedic surgeons, sports medicine doctors, plastic surgeons, hand surgeons and rheumatologists.
Following surgeries are there to treat a severe condition of trigger finger where physical therapy remedies fail to cure it. Though the recovery time for its surgery is quick and the procedure too has a high chance of success.
- Open Surgery: In this type of surgery, using local anaesthesia, a surgeon makes a small cut in the palm of the hand, then in the tendon sheath to give the tendon more space to move. He uses stitches to close the wound. Patients should keep the dressing on their finger for a few days following an open surgery till the finger pain totally subsides. They can remove the cover after a few days but must keep the wound clean.
- Percutaneous release Surgery : This is also done using a local anaesthetic. In this a needle is inserted by the surgeon into the bottom of the digit to cut the tendon sheath. This type of surgery does not leave any wound and it is even cost effective. People have an equal level of long term satisfaction with both Open and Percutaneous release surgery. This surgery will take around 20 minutes and the patient does not have to stay overnight in the hospital. It may initially cause some pain or soreness. Related to that the doctor may recommend over-the- counter pain killers for relief. Be gentle with the movement first. Full movement is expected to return in one to two weeks.
- Tenosynovetomy : If the doctor says that the above two surgeries are not suitable, then this type of surgery is done. For example for the patients with rheumatoid arthritis. In this the part of tendon sheath is removed which automatically allows the finger to freely move.
The prognosis of the trigger finger is excellent. Nearly all the patients recover completely of finger pain after following remedies of medical professionals. People can prevent trigger finger by avoiding such activities that strain continuously the tendons in the palm of their hand.