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Trigger Finger (Stenosing Tenosynovitis)

Trigger finger is a common condition affecting the finger/s or thumb. Also called stenosing tenosynovitis, trigger finger makes it difficult for you to straighten your finger coming from a bent position. If the condition affects your thumb, it is called trigger thumb.

Normally, your finger tendons slide smoothly through a series of small passageways in your fingers as you bend and straighten them. Tendons are cord-like fibers that attach muscles to bones. The small passageways where the finger tendons pass through are called the tendon sheaths. These sheaths keeps your finger tendons in place next to the bones.

In trigger finger, the tendon or sheath become inflamed or swollen. As a result a section of the tendon is enlarged or the tendon sheath becomes tighter. This makes it harder for the tendon to pass through wherein it can "catch" or temporarily locks at the narrow passageway and then suddenly release like a "trigger" as it overcomes the resistance when you straighten your finger.

Causes

Any activity or condition that results in inflammation or swelling of the tendon or sheath can cause trigger finger to develop including:
  • Rheumatoid arthritis
  • Long-term use of hand tools such as hand drill and wrench
  • Long-term repetitive movements of the fingers, such as that occurs when playing video games or texting using mobile phones
In most cases, however, the cause of trigger finger is unknown.

Symptoms

Symptoms of trigger finger may include:
  • Feeling of snapping (triggering) on the affected finger/s as you straighten or bend your finger/s
  • Pain when finger is bent or straightened
  • Swelling
  • Finger joint stiffness

Physical Therapy Treatment Options for Trigger Finger/Trigger Thumb
  • Rest
  • Ice/Heat
  • Stretching
  • Mobilization Techniques
  • Range of Motion (ROM) Exercises
  • Strengthening Exercises
  • Patient Education
  • Recommend splinting

Other Medical Treatment Options for Trigger Finger

In some, more serious cases, your doctor may recommend pain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDS) and steroid injection; percutaneous trigger finger release; or surgery to release the tendon.

See video below on a discussion on trigger finger by Dr. Kerrigan of the Dartmouth-Hitchcock Hand Clinic. A few things discussed on the video include risks, as well as, the benefits of non-surgical treatments as compared to the surgical approach.



Video Source: Dartmouth-Hitchcock (2009, September 24). Trigger Finger [Video File]. Retrieved from http://www.youtube.com/watch?v=iAIzUb4cl4M

Suggested Readings
References:
What is Trigger Finger? University Sports Medicine. http://www.ubsportsmed.buffalo.edu/education/trigger.html. Accessed September 11, 2010.

Trigger finger. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=A00024. Accessed September 11, 2010.

Finger Injuries and Disorders. National Library of Medicine. http://www.nlm.nih.gov/medlineplus/fingerinjuriesanddisorders.html. Accessed September 11, 2010.

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