Trigger Finger

Tendons connect bones to muscles in the body. Flexor tendons of the thumb and fingers pull the fingers into a fist. The tendons are enclosed in a synovial sheath. When this sheath becomes inflamed it is called trigger finger.

Usually, tendons slide easily through the sheath as the finger moves. In the case of trigger finger, the synovial sheath is swollen. The tendon cannot move easily. This causes the finger to remain in a flexed (bent) position. In mild cases, the finger may be straightened with a “pop”. In severe cases, the finger becomes stuck in the bent position.

What causes it?

• Overuse of the hands from work or recreational activities
• Occupations involving repetitive finger movements e.g.: long hours of grasping a steering wheel or use of pistol gripped power tools
• Direct injury resulting in microtrauma to the tendon sheath
• Partial tendon lacerations
• Contributing factors can be an associated medical condition such as rheumatoid arthritis, diabetes, hypothyroidism, gout
• It commonly co-exists with other hand disorders such as carpal tunnel syndrome, de Quervains tenosynovitis, Dupuytrens contracture

What can a doctor do to help?

• Your doctor may choose to inject a corticosteroid — a powerful anti-inflammatory medication — into the tendon sheath. In some cases, this improves the problem only temporarily, and another injection is needed. If two injections fail to resolve the problem, surgery should be considered.
• Prescribe hand therapy and/or a custom prescription splint for conservative management.
• The goal of surgery is to widen the opening of the tunnel so that the tendon can slide through it more easily. The surgery is performed through a small incision in the palm or sometimes with the tip of a needle. The tendon sheath tunnel is cut. When it heals back together, the sheath is looser and the tendon has more room to move through it.

What can a therapist do to help?

• Help identify aggravating activities and suggest alternative postures.
• Massage, heat, ice and other treatments aimed at making the area more comfortable.
• A custom-made splint, which limits finger bending, can help reduce the inflammation and elevate the symptoms.