Description
Trigger finger or tenosynovitis (ten-oh-sin-oh-VY-tis) is an inflammation of the tendons (cordlike fibers that attach muscle to bone) and synovium (a slick membrane that allows the tendons to move easily) in your finger. Swelling of these tissues causes pain, stiffness, and a locking or catching sensation when you bend or straighten your finger. This occurs most commonly inside your ring finger or thumb, but can occur in any of the fingers.
Symptoms
- Pain
- Stiffness
- Locking or catching sensation when bending and straightening the finger
- Tender lump at the base of the finger on the palm side of the hand
- Stiffness and locking tend to be worse in the morning or after periods of inactivity
- In severe cases the finger will remain locked in bent position
Causes
- Repeated gripping or grasping activities
- Arthritis
- Injury to the palm of the hand
- However, the cause of trigger finger is often unknown.
Risk Factors
- Medical conditions: diabetes, rheumatoid arthritis
- Forceful hand activities- pinching and grasping
Prevention
- Avoid repetitive gripping and grasping (ex. Using a wrench or drill)
Diagnosis
Your doctor will discuss your symptoms, review your medical history, and complete a thorough physical evaluation of your hand and finger. Typically, x-rays or other tests are not needed to diagnosis trigger finger.
During the exam, your doctor will look for:
- Tenderness over the flexor tendon sheath in the palm of your hand
- Thickening or swelling of the tendon sheath
- Triggering when you bend and straighten your finger
Treatment
The initial treatment method for trigger finger injuries is non-operative, and there are a variety of methods available. If non-operative treatments do not relieve your symptoms, your doctor may recommend a surgery called tenolysis” or “trigger finger release.” The purpose of a trigger finger release is to open the tendon sheath to allow more space for the tendon.
Non-operative
- If your symptoms are mild:
- Rest
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Splinting
- Rehabilitation exercises
- If this does not reduce the swelling, your doctor may give you injections of an anti-inflammatory, such as cortisone, in the base of the finger or thumb.
- Before an injection, the area with be sterilized and numbed.
Goal
- Improve the patient’s symptoms and provide a better quality of life
Benefits
- Symptoms may be eliminated with no surgical procedure necessary
- If injections are chosen as a method of treatment, they are very quick and minimally invasive. They can also help prolong surgery.
Recovery
- Recovery time will vary depending on the severity of the condition and the treatment options chosen.
Complications
- The patients symptoms do not improve
- The finger remains fixed in a bent position
- The patient must then resort to surgical methods.
Outcomes
- Most patients find that a combination of rest and NSAIDs allows them to heal within a few weeks.
- People who choose to treat the condition with injections alone may have a recurrence of symptoms.
