Our hands are in constant use throughout the day. Certain clinical conditions can affect the joints of our hands and can make day-to-day activities difficult. One such condition that can affect the fingers is trigger finger. Here we take a look at this condition in a little more detail.
Trigger finger is a condition where the sheath (thin layer of tissue) that surrounds the tendon of the fingers gets inflamed. This inflammation leads to narrowing of the space between the tendon and the sheath, leading to difficulty in extending the finger when it has been flexed. In other words, the finger can become locked in a folded position and will ‘click’ open when an attempt is made to extend it. This clicking motion sometimes looks and feels like pressing a trigger, hence the name.
Trigger finger is also called stenosing tenosynovitis.
The primary underlying cause of trigger finger is inflammation. This may occur spontaneously or following injury. Patients who have diabetes and rheumatoid arthritis are at a higher risk. Individuals whose job involves using the hands predominantly may be at risk.
Over time, the inflammation can lead to thickening of the tendons and the sheath, resulting in the triggering motion and difficulty moving the finger.
Trigger finger often affect the middle finger, ring finger and thumb. It is rarely painful. Patients often notice stiffness of the affected finger early in the morning. When attempting to extend a flexed finger, a clicking sensation may be observed. Some patients may also have a slight degree of tenderness over the area affected. In more advanced cases, the finger may remain in a bent position.
Diagnosis of trigger finger is often made through clinical examination. Patients may have a background history of diabetes and rheumatoid arthritis, which could be a clue.
Most cases of trigger finger can be treated conservatively by resting the affected joint and applying either heat pads or ice packs. In some individuals, wearing a splint that will help maintain the finger in an extended position may be advised. Exercises can help. Those individuals who suffer from pain may benefit from the use of non-steroidal anti-inflammatory drugs.
Steroid injections into the tendon sheath can help reduce inflammation and can restore easier movement. Steroids tend to be avoided in patients who have diabetes, as the blood sugar levels can increase significantly.
In individuals who do not respond to conservative and medical therapies, surgical options may be pursued. For instance, if steroids do not help, tendon release surgery may be performed. This is done under local anesthesia and a needle is inserted into the affected area in order to release the sheath and the tendons. This procedure is often performed on an outpatient basis. More complicated surgeries can be performed if required but are rarely done.Conclusion
Trigger finger is a well-recognized condition that can limit the movement of the finger. Conservative treatments, along with painkillers, are often sufficient, though steroids seem to have a great deal of benefit. Surgery is often reserved for patients who do not respond to other types of therapy.