Trigger Finger | Definition and Patient Education
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Trigger Finger

What is trigger finger?

Highlights

  1. Trigger finger occurs due to inflammation of tendons in the hand.
  2. Lifestyle changes and activity avoidance are often effective treatments for trigger finger.
  3. Corticosteroid treatment may also be effective, but your symptoms may return after this treatment.

Trigger finger occurs due to inflammation of the tendons in the hand, causing hand tenderness, pain, and deformity. The condition limits your finger’s movement and can make it impossible to straighten your finger.

What are the symptoms of trigger finger?

Symptoms

Common early symptoms include:

  • a lingering soreness in the base of your thumb or another finger
  • a bump or lump around the base of your finger near the palm
  • tenderness around the base of your finger
  • a clicking or snapping noise with movement
  • stiffness in your affected finger

If you don’t get treatment for it, trigger finger can progress. Advanced symptoms include a thumb, another finger, or both being locked in a bent or straight position. You may also be unable to uncurl your finger without using the other hand if you have an advanced case of trigger finger.

The symptoms of trigger finger tend to be worse in the morning. The finger typically starts to relax and move more easily as the day goes on.

What causes trigger finger?

Causes

Your fingers have several small bones. Tendons connect these bones to muscles. When your muscles contract or tighten, your tendons pull on your bones to move your fingers.

Long tendons, called flexor tendons, extend from your forearm to the muscles and bones in your hands. Flexor tendons slide through a flexor tendon sheath, which is like a tunnel for the tendon. If the tunnel narrows, your tendon cannot move easily. This is what occurs in trigger finger.

When the tendon slides through the narrowed sheath, it becomes irritated and swells. Motion becomes extremely difficult. Inflammation may cause a bump to develop, which further restricts movement. This causes your finger to stay in a bent position, and it becomes extremely difficult to straighten it.

Who is at risk for trigger finger?

Risk Factors

Some people are more likely to have trigger finger than others. For example, according to the American Academy of Orthopedic Surgeons, it’s more common in women than in men.

Other risks factors associated with trigger finger include:

  • being between the ages of 40 and 60
  • having diabetes
  • having hypothyroidism
  • having rheumatoid arthritis
  • having tuberculosis
  • performing repetitive activities that can strain your hand, such as playing a musical instrument or repeatedly using hand tools

According to the Cleveland Clinic, trigger finger most commonly affects musicians, farmers, and industrial workers.

How is trigger finger diagnosed?

Diagnosis

A doctor can usually diagnose trigger finger with a physical exam and some simple questions about medical history.

Your doctor will listen for characteristic clicking upon movement. They’ll look for a bent finger. They may also observe you opening and closing your hand. Diagnosis will not typically require an X-ray or further imaging testing.

How is trigger finger treated?

Treatment

At-home treatments

Treatments depend on the severity of the symptoms. At-home treatments include:

  • taking a break from repetitive activities for four to six weeks
  • wearing a brace or splint to restrict motion and rest the hand
  • applying heat or ice to reduce swelling
  • placing your hand in warm water several times throughout the day to relax the tendons and muscles
  • gently stretching your fingers to enhance their range of motion

Medications

Medications may help relieve inflammation. Anti-inflammatory medications include:

  • ibuprofen
  • naproxen
  • prescription anti-inflammatories
  • steroid injections

Surgery

If medications and at-home treatments don’t work, your doctor may recommend surgery. Surgeons perform surgery for trigger finger on an outpatient basis. After you get an anesthesia shot, your surgeon makes a small cut in the palm and then cuts the tightened tendon sheath.

As the tendon sheath heals, the area is looser, helping your finger move more easily. Surgery risks include infection or ineffective surgical results.

Surgery recovery can take several weeks to six months. Your doctor may recommend physical therapy exercises to relieve post-surgery stiffness, but it isn’t necessary usually. As a general rule, once the doctor releases the tendon sheath, the tendon can move freely and people can return to their normal activities within a few days. Your doctor will remove the sutures in 7-14 days.

What is the outlook for people with trigger finger?

Outlook

Lifestyle changes and activity avoidance are often effective treatments for trigger finger. Corticosteroid treatment may also be effective, but the symptoms may return after this treatment. According to a study published in the Journal of Bone and Joint Surgery, researchers found that symptoms had returned in 56 percent of patients by one year after receiving corticosteroid injection treatments. These symptoms typically came back several months after receiving the shot. However, the injection is quick and simple, and it can allow you to put off having surgery until a time that’s more convenient.

The researchers in this study also found that patients with insulin-dependent diabetes, who were also younger and had several symptomatic fingers, were more likely to have symptoms that return.

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