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Trigger Finger

Summary:


Trigger finger or stenosing tenosynovitis is a condition when the finger or thumb is “locked” in a bent position.




Contents

What is Trigger Finger?

Trigger finger or stenosing tenosynovitis is a condition when the finger or thumb is “locked” in a bent position. The finger may click as it straightens – simulating a trigger being pulled and released in a gun.


What are the common causes?

The specific cause for trigger finger is usually not clear. However, people whose work or hobbies require repetitive grasping or gripping movements, and heavy lifting are at a higher risk of developing this condition. Sometimes, trigger fingers may be associated with medical conditions such as rheumatoid arthritis and diabetes. Trigger finger is caused by inflammation and swelling of the tendon or tendon sheath.

  • A tendon is like a rope that attaches the muscle to the bone. As the muscle pulls on the tendon, the finger will bend towards the palm.
  • Tendon sheath is like a cover that wraps around the tendon to help it glide smoothly when the finger bends and straightens.
  • Pulleys form a tunnel to hold the tendon close to the bone.

Swelling makes it difficult for the tendon to glide through the pulley tunnel, resulting in triggering.


What are the signs and symptoms?

  • Pain and swelling at the base of the finger or thumb.
  • Clicking or triggering when the affected finger moves.
  • Involved finger is locked in a bent position.
  • Finger stiffness, especially in the morning.

What types of treatment are available?

Hand Therapy

The primary goal of therapy is to help you to return to a pain-free participation in your work and daily activities, and minimise or eliminate occurrence of trigger finger / thumb.

The therapist will explain to you what Trigger Finger / or Stenosing Tenosynovitis is, so that you can have a better understanding of what you can do to reduce your pain. You will also learn how to modify the way you perform your daily activities so as to avoid recurrence of the symptoms.

As the initial stage of therapy involves managing the pain and swelling, a splint will be made for you to rest the involved structures. You are advised to wear it for at least 6 weeks. The splint limits movement of your affected finger / thumb, thus allowing the inflamed tendons and / or tendon sheaths to have a rest. Thus even with the splint on, you will be able to continue using your hand to do light activities.

You will be taught simple exercises to move your affected finger / thumb to prevent joint stiffness.

What can I do to help myself?

How can I prevent it?

  1. Avoid performing repetitive grasping or grasp-and-release motions. Such motions, particularly when performed with a sustained pinch, are common causes of developing a trigger finger. Tasks to avoid include wringing clothes/towel/mop, cutting with a pair of scissors and plant-pruning.


  1. Avoid using power grips. A power grip is when your fingers, or sometimes palm, hold onto an object with your thumb providing the counter pressure. Examples are when you are using a hammer, opening a jar, doing pull-ups or holding your steering wheel when driving.


How can I help myself once I have it?

  1. Take frequent short breaks. If you are unable to avoid the repetitive and forceful gripping actions during an activity, you should make an effort to intersperse it with other lighter tasks, or take regular breaks to do some stretches.

FAQ

  1. How long do I have to wear the splint? Splinting is recommended for at least 6 weeks.
  2. How many sessions of therapy do I have to attend? It depends on the severity of your trigger finger/thumb. A mild case of trigger finger/thumb may only require a couple of therapy sessions.
  3. Will conservative (non surgical) treatment help to relieve my symptoms? Research has shown that the rate of successful outcomes with splinting can be from 70%3 up to 92.9%.1
  4. Will the symptoms return? Unless you make an effort to change the way you perform your daily activities and work, the symptoms can recur.

References

  1. Colbourn, J., Heath, N., Manary, S. & Pacifico, D. (2008). Effectiveness of Splinting for the Treatment of Trigger Finger. Journal of Hand Therapy, 21; 336-343.
  2. Mayo Foundation for Medical Education and Research (MFMER). (1998-2010). Trigger Finger. [Online]. Available: https://www.mayoclinic.org/diseases-conditions/trigger-finger/diagnosis-treatment/drc-20365148 (5 January, 2010).
  3. Nimigan, A. S., Ross, D. C. & Gan, B. S. (2005), Steroid Injections in the Management of Trigger Fingers. American Journal of Physical Medicine & Rehabilitation, 85(1); 36-43.
  4. Stanley, B. G. & Tribuzi, S. M. (Eds.) (1992). Concepts in Hand Rehabilitation. USA: F. A. Davis Company.
  5. The Hand Rehabilitation Center of Indiana. (2001). Diagnosis and Treatment Manual for Physicians and Therapists. (4th ed.) USA: The Hand Rehabilitation Center of Indiana.
- Last updated 23 Jan 2018,2:03 pm




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