Trigger Finger: Understanding Stenosing Flexor Tenosynovitis

September 8, 2023

Introduction to Trigger Finger: Symptoms and Causes

Trigger finger, also known as stenosing flexor tenosynovitis, is a condition that affects the tendons in the fingers and thumb. It occurs when the tendons that bend the fingers become inflamed, making it difficult to straighten or bend the affected finger or thumb.

Symptoms

The most common symptom of trigger finger is a popping or clicking sensation when trying to bend or straighten the affected finger or thumb. This is often accompanied by pain and stiffness in the finger or thumb, especially in the morning or after periods of inactivity. Other symptoms may include:

  • Tenderness at the base of the affected finger or thumb, where the tendon passes through the palm.

  • Swelling in the affected finger or thumb.

  • Buckling or the finger or thumb getting stuck in a bent position, and needing to be straightened manually.

  • Finger lock or the finger or thumb getting stuck in a bent position and unable to be straightened.

Causes

There are several factors that can contribute to the development of trigger finger, including:

  • Overuse: Repetitive motions, such as gripping or grasping, can put stress on the tendons in the fingers and thumb, leading to inflammation and triggering the condition.

  • Age: As we age, the tendons in our fingers and thumbs can become less flexible, making them more susceptible to injury and inflammation.

  • Certain Medical Conditions: People with conditions such as rheumatoid arthritis, diabetes, and gout are at a higher risk of developing trigger finger.

  • Trauma: Injuries to the hand or fingers can also contribute to the development of trigger finger.

If you suspect that you may have trigger finger, it is important to see a healthcare provider for an examination and diagnosis. They will be able to recommend an appropriate treatment plan to help manage your symptoms and prevent the condition from worsening.

It is important to note that trigger finger is a progressive condition, and early intervention can help prevent it from getting worse. If you have any of the symptoms described above, it is important to see your healthcare provider as soon as possible.

Diagnosis and Treatment Options for Trigger Finger

Once a healthcare provider has identified that you have symptoms of trigger finger, they will perform a physical examination of your hand and fingers to confirm the diagnosis. The examination may include tests such as:

  • Tenderness at the base of the affected finger or thumb, where the tendon passes through the palm.

  • Swelling in the affected finger or thumb.

  • Range of Motion testing to see if the affected finger or thumb can be straightened or bent easily.

  • Palpation of the affected finger or thumb to feel for any bumps or lumps, which can indicate the presence of a nodule or thickening of the tendon.

Treatment Options

Treatment for trigger finger depends on the severity of the condition and can include:

Non-surgical Management

  • Rest and Splinting: Resting the affected finger or thumb and wearing a splint to keep it in a straight position can help reduce inflammation and allow the tendon to heal.

  • Physical Therapy: Stretching and strengthening exercises can help improve the flexibility and strength of the tendons in the fingers and thumb, reducing the risk of further injury.

  • Medications: Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can be used to help reduce pain and inflammation.

Surgical Management

  • Corticosteroid Injections: Injections of corticosteroids into the area around the tendon can help reduce inflammation and pain.

  • Surgery: In some cases, surgery may be necessary to release the affected tendon and allow it to move more freely.

It is important to note that trigger finger is a progressive condition, and early intervention can help prevent it from getting worse. Your healthcare provider will work with you to determine the best course of treatment for your individual needs.

It is also important to prevent recurrence of the condition by avoiding repetitive motions, using proper ergonomics, and maintaining good hand and finger hygiene.

If you are experiencing symptoms of trigger finger, it is important to see a healthcare provider to get an appropriate diagnosis and treatment plan. With the right treatment, you can manage your symptoms and prevent the condition from worsening.

Non-surgical Management of Trigger Finger

Non-surgical management is the first line of treatment for trigger finger and can be effective in managing the symptoms of the condition. The goal of non-surgical management is to reduce inflammation and pain, and to improve the flexibility and strength of the tendons in the fingers and thumb.

Rest and Splinting

One of the most effective ways to manage trigger finger is to rest the affected finger or thumb and to wear a splint to keep it in a straight position. This can help reduce inflammation and allow the tendon to heal. A splint can be worn at night or during activities that aggravate the symptoms.

Physical Therapy

Physical therapy is another important aspect of non-surgical management for trigger finger. A physical therapist will work with you to develop a customized exercise program that includes stretching and strengthening exercises for the fingers and thumb. These exercises can help improve the flexibility and strength of the tendons, reducing the risk of further injury.

Medications

Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can be used to help reduce pain and inflammation associated with trigger finger. These medications can be taken orally or applied topically to the affected area.

It is important to note that non-surgical management may not be effective for everyone and in some cases, surgery may be necessary to fully resolve the symptoms. Your healthcare provider will work with you to determine the best course of treatment for your individual needs.

It is also important to prevent recurrence of the condition by avoiding repetitive motions, using proper ergonomics, and maintaining good hand and finger hygiene.

If you are experiencing symptoms of trigger finger, it is important to see a healthcare provider to get an appropriate diagnosis and treatment plan. With the right treatment, you can manage your symptoms and prevent the condition from worsening.

Surgical Management of Trigger Finger

In some cases, non-surgical management may not be effective in managing the symptoms of trigger finger, and surgery may be necessary to release the affected tendon and allow it to move more freely.

Corticosteroid Injections

Corticosteroid injections can be used to reduce inflammation and pain in the affected tendon. These injections are usually performed by a healthcare provider in the clinic setting and can provide relief for several months.

Surgery

Surgery for trigger finger is known as percutaneous release, it is usually performed as an outpatient procedure, meaning the patient can go home the same day. During the surgery, a small incision is made in the skin, and the affected tendon is released, allowing it to move more freely. The surgery is usually done under local anesthesia and the procedure takes about 20-30 minutes.

It is important to note that recovery time varies depending on the individual, but most patients can return to normal activities within a few weeks.

It is also important to prevent recurrence of the condition by avoiding repetitive motions, using proper ergonomics, and maintaining good hand and finger hygiene.

If you are experiencing symptoms of trigger finger, it is important to see a healthcare provider to get an appropriate diagnosis and treatment plan. Your healthcare provider will work with you to determine the best course of treatment for your individual needs. With the right treatment, you can manage your symptoms and prevent the condition from worsening.

Recovery and Prevention of Recurrence in Trigger Finger

Recovery from trigger finger can take several weeks, depending on the individual and the severity of the condition. It’s important to follow the instructions provided by your healthcare provider to ensure proper recovery and to prevent recurrence of the condition.

Recovery after Non-surgical Management

  • After non-surgical management, it is important to rest the affected finger or thumb and to wear a splint as instructed by your healthcare provider.

  • Physical therapy may be recommended to help improve the flexibility and strength of the tendons in the fingers and thumb.

  • Medications may be prescribed to manage pain and inflammation.

Recovery after Surgery

  • After surgery, it is important to follow the instructions provided by your healthcare provider regarding wound care and physical therapy.

  • You will likely be instructed to keep your hand elevated and to avoid using the affected finger or thumb for a period of time.

  • Physical therapy may be recommended to help improve the flexibility and strength of the tendons in the fingers and thumb.

Prevention of Recurrence

To prevent recurrence of the condition, it is important to:

  • Avoid repetitive motions that put stress on the tendons in the fingers and thumb.

  • Use proper ergonomics when performing tasks that involve gripping or grasping.

  • Maintain good hand and finger hygiene to prevent the development of any nodules or thickening of the tendon.

  • Keep diabetes and other medical conditions that increase the risk of developing trigger finger under control.

If you have been diagnosed with trigger finger and have undergone treatment, it is important to continue to monitor your symptoms and to see your healthcare provider if they worsen. With proper care and management, you can reduce the risk of recurrence and continue to lead an active and healthy lifestyle.

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