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.
Symptoms may include:
- A tender lump in your palm
- Catching or popping sensation in your finger or thumb joints
- Pain when bending or straightening your finger
Your doctor can diagnose the problem by talking with you and examining your hand. No other testing or x-rays are usually needed to diagnose trigger finger.
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.
Schedule an Appointment
For an integrated approach to Occupational Therapy services, contact us on the details below.
Hands, Lymphoedema & Breast Cancer
011 475 9480
Neurological and Adult Physical Rehabilitation
060 477 9950