Trigger Finger

Trigger Finger

Hand and Wrist ​Condition

Trigger Finger

Trigger finger limits the finger’s movement. When you try to straighten your finger, it will lock before getting straight.

Trigger finger is a condition that affects the finger tendons.

Anatomy

Tendons are the structures that connect muscles to bone. When the muscles contract, the tendon pulls the bone. This is what causes most parts of the body to move.

The muscles that move the fingers are located in the forearm, above the wrist. Long tendons – called flexor tendons – travel from the muscles through the wrist and attach to the small bones of the fingers.

These flexor tendons control the movements of the fingers. When you flex or extend your finger, the flexor tendon slides through a tight tunnel, called the tendon sheath, that holds the tendon in place.

The flexor tendon may be irritated when it slides through the tendon sheath. As it suffers more and more irritation, the tendon can thicken and nodules can be formed, making it more difficult to pass through the tunnel.

The tendon sheath can also thicken, and that causes the tunnel diameter to shrink. If you have trigger finger, the tendon is momentarily locked at the tendon sheath when you try to extend your finger.

Causes

The cause of trigger finger is usually unknown. There are factors that put you at greater risk of developing trigger finger.

  • It’s more common in women than in men.
  • It occurs more frequently in people between the ages of 40 and 60.
  • It’s more common in people with certain medical problems, such as diabetes and rheumatoid arthritis.
  • It can occur after activities that make the hand strain.
Symptoms

Trigger finger symptoms usually begin without any injury, although they can follow a period of heavy hand use. Symptoms may include:

  • A painful lump in the palm of your hand
  • Inflammation
  • Feeling of paralysis or pressure in the finger joints
  • Pain when flexing or extending your finger
  • Stiffness and immobilization tend to get worse after inactivity, for example when you wake up in the morning. Your fingers often loosen as you move them.
  • Sometimes, when the tendon gets torn and loose, you may have a feeling of dislocation in the finger joint.
  • In severe cases of trigger finger, the finger cannot be extended, even with help. Sometimes one or more fingers are affected.
Treatment
Non-surgical treatment
  • Rest
  • NSAID’s
  • Steroid injections
Surgical treatment

Trigger finger is not a dangerous condition. The decision to undergo surgery is a personal decision, based on the severity of the symptoms and if the non-surgical options have failed. Also, if your finger is locked in a flexed position, your doctor may recommend surgery to prevent permanent stiffness.

Surgical intervention

The goal of surgery is to expand the tunnel opening so that the tendon can slide through it more easily. This is usually done in an outpatient setting, which means that you should not stay overnight in the hospital.

Most people receive an injection of local anesthesia that numbs the hand for intervention.

The surgery is performed through a small incision in the palm or sometimes with the tip of a needle. The tunnel of the tendon sheath is cut. When it heals, the sheath is more lax and the tendon has more space to move through it.

Recovery

Most people can move their fingers immediately after surgery.

It is common to feel some burning in the palm of the hand. Frequently, raising your hand above the level of the heart can help reduce inflammation and pain.

Recovery is usually completed in a few weeks, but it can take up to 6 months for all the inflammation and stiffness to go away. If your finger was considerably stiff before surgery, physical therapy and finger exercises can help loosen it.