Trigger Finger syndrome is a painful condition that characterizes sudden snapping or locking of one of the fingers while opening or closing the fist. Just like the trigger of a pistol being pulled, any of the five fingers may bend or straighten suddenly with a jerk, hence the name. It mainly occurs due to inflammation narrowing the space between the tendon and the sheath that surrounds it in the affected finger. In case of severe condition, the affected finger may become locked in a bent position for a long duration.
Medically referred to as ‘Stenosing tenosynovitis’, this condition may appear in one or two fingers at a time or even in the hand. When this painful condition affects the thumb, it is known as ‘trigger thumb’.
Tendons are tough fibrous cords that attach muscles to bones. The tendons are usually surrounded by a protective synovium sheath that lubricates it and helps it to move smoothly or glide to carry out various movements. Due to repeated movement or forceful use of the finger or thumb, this sheath around the tendon of your finger becomes inflamed and swollen. This can restrict the normal gliding motion, leading to the finger getting locked and staying bent.
A more prolonged and severe irritation of the tendon sheath can cause thickening, scarring and the formation of small bumps in the tendon that hinder the normal motion of the tendons and eventually the finger even more.
Some causative factors that increase the risk of Trigger finger include:
Age: The condition is more common in people between ages 40 and 60.
Gender: Women are more prone to trigger finger than men.
Occupation: People who are involved in occupations and hobbies which involve repetitive gripping or hand use like farmers, musicians, industrial workers, gardeners etc are more at risk of having trigger finger.
Surgical Procedure: Trigger finger may happen as a complication or side effect associated with the surgery done for carpal tunnel syndrome in the first 6 months after operation.
The common signs and symptoms initially start mild and gradually the pain increases with time. The finger usually gets locked when you try to grasp something or try to open the fist and straighten your fingers. The common symptoms of trigger finger include:
- Stiffness in the affected finger, especially in the morning
- A feeling of popping or clicking as you try to move the finger
- Finger getting locked in a bent position, which suddenly pops straight
- Finger snapping and unable to straighten
- Presence of a bump or a nodule or soreness in the palm at the base of the affected finger
Diagnosis And Treatment
If you have a locked finger that you cannot straighten normally, do visit a doctor to ease the pain and inflammation. Although the doctor may not conduct any elaborate diagnostic procedures, he or she usually acknowledges the past medical history or the occupation one does as to correctly understand the reason behind the trigger finger. The doctor also does a thorough physical exam where the patient is asked to slowly open and close the fist, so as to analyse the areas of pain, the smoothness in the motion and evidence of locking or snapping. The doctor also looks for any lump or swelling at the base of the trigger finger.
Treatment options usually depend upon the severity of the symptoms. These include:
Rest: Taking adequate rest is extremely necessary to slowly let the inflammation in the tendons subdue.
Splints: The doctor may provide a splint to keep the finger still and avoid motion.
Stretching Exercises: Apart from resting, certain mild stretching exercises are necessary to gently ease the stiffness and improve range of movement.
Medications: To help ease the pain and inflammation, the doctor may prescribe over-the-counter anti-inflammatory drugs like NSAID’s.
Steroid Injections: In case of more pain, the doctor can sometimes directly give a steroid shot in the inflamed tendon to ward off the symptoms of trigger finger.
Percutaneous Release: This procedure involves the insertion of a needle in the affected tendon and moving it slowly so that the finger gradually helps break apart the constriction that's restricting smooth movement.
Tenolysis Surgery: In case of a severe condition, the doctor or surgeon usually does a small incision near the base of the affected finger, to cut open the compressed section of tendon sheath.