Trigger finger, also known as stenosing tenosynovitis, describes a physical condition in which a person has difficulty using one or more fingers on their hands at the same time. Tendon and joint problems cause a finger to become stuck in a bent position similar to how a person must bend their finger to use a gun trigger. Any attempt to unbend it manually by flexing the fingers outward or pulling on the affected finger typically doesn't work. People often experience this condition after intensive, repetitive hand usage and while experiencing general physical stiffness shortly after waking in the morning. They notice it while trying to flex and straighten their fingers after sleep or while attempting to grasp objects.
Many people use the term trigger thumb as an alternative description, but trigger thumb merely describes a separate version of the same condition that only occurs with the thumb rather than one of the four other digits.
Causes of Trigger Finger
Fibrous cords in the hands and other areas of the body known as tendons join bone to muscle and aid with a gliding motion in the body's use of mechanical force. In the hands, a person can't move their fingers without the help of connective tissues known specifically as flexor tenons. Each flexor tendon has a protective sheath around it that can become irritated with use and general, age-related wear and tear. The irritation causes swelling that leads to the sheath interfering with tendon functionality. Additional damage caused by repeated cases of inflammation, including nodule formation and sheath thickening and scarring, can make trigger finger worsen and occur more often as a person ages.
With any digit, arthritis in nearby finger joints and diabetes symptoms can exacerbate the problem. High risk individuals also include women, especially those with hobbies or jobs that require fine motor skills or who have experienced severe hormone changes with pregnancy and aging, anyone who strains or repetitively uses their fingers in bent or gripping positions and carpal tunnel syndrome (CTS) sufferers. People who had carpal tunnel surgery can also experience temporary trigger finger during recuperation or as a longer-lasting complication.
Signs of Trigger Finger
Beyond the well-known bent position of a finger during a trigger finger event, a person can also eventually experience sudden and sometimes painful finger straightening. The bent digit suddenly "snaps" or "pops" outward into a straight, released position after improvement of tendon sheath inflammation and irritation. Prior to a trigger finger event, people usually receive several warnings from their bodies. They again typically feel moderate-to-severe stiffness in one or more fingers, especially after rest and in the morning. They might experience heat and tenderness in the finger and a clicking or popping sensation while using it. They might also physically feel or visually see a bump or lump at the base of the finger.
A person who recently finished a repetitive, hand-intensive task might notice pain and stiffness in the wrist or elbow of the same arm. People who have CTS might experience sudden wrist stiffness and pain. Those who recently had CTS surgery that alters and inflames carpal tunnel tendons and nearby wrist structures might not experience any forewarning beyond heat and tenderness in the wrist.
Treating Trigger Finger
Few people need surgery to treat this condition since rest and positive overall health and lifestyle changes can improve the health of the flexor tendons, joints and other structures and reduce the triggers of trigger finger. Doctors typically recommend the use of anti-inflammatory, pain medications and rest as initial conservative treatment. They also try to improve any underlying conditions like arthritis, diabetes and CTS. Once the finger straightens, they may attach a splint temporarily to help with stretching the affected tendons and preventing finger bending or curling during rest. They might recommend physical therapy as well or exercises that require a person to stretch and flex their fingers outward regularly. Some doctors even recommend that their patients bend their fingers slightly, place a rubber band loosely around them near the tips and then flex outward to add light resistance to the exercises.
Sometimes a finger infection can present symptom-wise as trigger finger. If a person experiences severe inflammation and pain, their doctor might recommend an emergency room visit to rule out infection. With a more long-term or severe, non-infection case, a doctor usually recommends injections to reduce sheath inflammation or the use of a needle or surgery to release tendon constriction and correct any nearby structural problems.