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Trigger Finger

Introduction

Trigger finger is known medically as stenosing tenosynovitis. One of your fingers or your thumb gets stuck in a bent position, then straightens with a snapping motion. Trigger finger is not a dangerous condition, but can become quite painful. Sometimes, your finger may become locked in the bent position, which makes it useless during normal hand movements.

 

Anatomy of Trigger Finger

Each finger and thumb in your hand uses a flexor tendon during movement. Each tendon is encased in a tendon sheath, which is lined with a substance called tenosynovium. The tenosynovium secretes lubricating fluid into the tunnel within the sheath. During movement, each tendon will slide back and forth through the tendon sheath tunnel. If the tenosynovium becomes irritated and swollen the tunnel will become constricted and the tendon will not be able to move freely. If the tendon becomes irritated, tendon nodules can occur. Tendon nodules prevent the tendon from moving freely through the tunnel during movement.

 

Diagnosis and Treatment

Diagnosis of trigger finger can be completed by your physician with a complete history and physical exam. Usually, no other tests are needed to diagnose trigger finger. In rare cases the doctor may inject anesthetic into the affected hand to facilitate a proper examination.

 

Non-surgical treatment options include rest, medication or steroid injections. Surgical treatment is recommended if your finger is stuck in a bent position. Mild symptoms of trigger finger may only need finger rest to resolve the condition. A splint may be used to keep the finger in a resting position until the inflammation resolves. Also, non-steroidal anti-inflammatory medications or acetaminophen may be recommended to reduce the swelling. Steroid injections into the tendon sheath may be another recommended option. Injections may only relieve symptoms temporarily and a second injection may be necessary. If a second injection does not eliminate the problem, surgery is recommended. Sometimes the placement of the needle alone will release a stuck trigger finger.

 

Surgical treatment for trigger finger involves cutting the tendon sheath to allow the flexor tendon to slide freely through the sheath. Usually, local anesthesia is used to numb the hand and a small incision is made in the hand to allow the surgeon access to the tendon sheath. A cut is made in the sheath, which causes the tunnel to widen and allow proper tendon movement.

 

Risk Factors

Trigger finger occurs more often in women than men and affects women between the age of 40 to 60 the most. Activities that cause hand strain due to repetitive or forceful use of the digits may increase the risk of trigger finger. Therefore, it is more common in the dominant hand, affecting the thumb, ring finger or middle finger most often. Some medical conditions, such as rheumatoid arthritis, gout and diabetes can increase the risk of trigger finger.

 

Prevention

Trigger finger can be prevented by changing the routine of any repeated gripping actions. Occupational therapists may be able to suggest alternative motions to prevent trigger finger symptoms. Since the symptoms appear more pronounced in the morning, soaking your hand in hot water can help relieve inflammation. Soaking can be done throughout the day if it provides relief. Hand massage may help relieve the pain that accompanies trigger finger pain, but it will not help eliminate the inflammation.





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