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Trigger finger
Trigger finger

Trigger finger happens when tendons in the finger become inflamed or swollen: Bending the finger may pull the inflamed tendon through a narrowed tendon sheath, making it snap or pop. The closure often hurts at the base of the digit on the palm of the hand. Some people are more at risk of getting the disease, e.g. people whose work or hobbies require repetitive gripping actions, people with diabetes, gout or rheumatoid arthritis. Treatment depends on the severity of the condition.


Symptoms of trigger finger

Signs might include:

  • Soreness at the base of the finger
  • Stiff finger, especially in the morning
  • Painful snapping or clicking sensation if the finger is bent or straightened
  • Bump in the palm at the base of the finger
  • Finger locked in a bent position, which cannot be straightened anymore
  • More than one finger might be affected, sometimes both hands
  • Hot, inflamed finger joint (possible infection)

Causes and origin of trigger finger

Trigger finger may be caused by a repeated movement or forceful use of the finger, or by an underlying illness, such as rheumatoid arthritis, diabetes and gouts. The condition occurs when the tendon sheath of the finger becomes irritated and inflamed. This interrupts the normal gliding motion of the tendon through the sheath. Persistent irritation of the tendon sheath may result in scarring, thickening and bumps that impede the tendon's motion even more.


Prevention and therapy of trigger finger

Therapy varies depending on its severity and duration. Nonsteroidal anti-inflammatory drugs, e.g. ibuprofen, might relieve the pain. However, the swelling probably won’t disappear with the medication.


Nonsurgical therapy

There are different options to treat the trigger finger, e.g. resting the finger for three to four weeks and avoiding all activities that have caused the condition. A splint at night for up to six weeks may also help: It keeps the finger in an extended position, and the tendon can rest. Moreover, the patient is not able to curl his/her fingers into a fist while sleeping. In this way, the affected person doesn’t have any pain when he/she moves the finger in the morning. Ice may also improve the condition. Gentle exercises maintain the mobility in the finger.


Other procedures

If the conservative treatments haven't helped, the physician may suggest an injection of a steroid medication near or into the tendon sheath. This might reduce inflammation and allow the tendon to glide freely again. The treatment is very common and cures the majority of the patients. Sometimes, a second injection is needed.
Another option might be percutaneous release: After numbing the palm, a sturdy needle is inserted into the tissue around the affected tendon. By moving it, the constriction that blocks the smooth motion of the tendon is broken apart. Via ultrasound control, the doctor makes sure the tendon or nearby nerves are not damaged.


Surgery

If none of the above treatments help, the patient gets surgery: The surgeon works through a small incision near the base of the finger and may cut open the constricted section of tendon sheath.


Preventive measures

By avoiding overuse of the finger, the condition can be prevented. If stiffness and swelling occurs, the finger should get plenty of rest. If the affected person alternates activities, the finger won’t become inflamed. In case it happens, ibuprofen may reduce inflammation before it gets worse.


14.10.2016 14:31:28