Trigger Finger

Have you ever had a trigger finger? A finger that locks, catches or doesn’t want to move normally? Trigger fingers occur when the tendons that flex the digit become inflamed and painful to move, making it difficult to straighten and bend. Sometimes it progresses to the point where all movement is restricted. 

Years ago, I was sure I needed to lift heavier free weights in order to get better and faster fitness results. This endeavor not only caused a ruptured disc in my neck but also a triggering of my right third digit. Apparently, this is a common problem in weight lifters, regardless of the weight. Clutching the barbell tightly and then moving it in repetitive motions exerts too much pressure on the tendons doing the work.

Tendons are bands of tissue that attach muscles to bones. In the hand, tendons and muscles must work together to flex and straighten our fingers and thumbs. Usually, they slide easily through a tunnel of tissue called a sheath. The sheath keeps them in place next to their respective bones. In a trigger finger or thumb, the tendons become irritated and swollen (inflamed) and can no longer easily slide through their sheaths. A bump (nodule) can then form on the tendon, which makes it even more difficult for the tendon to easily glide through its sheath, further restricting movement. The more the pressure as it goes through the sheath, the more it catches and the more it catches the bigger the knot. Prolonged irritation of the tendon sheath can result in the finger eventually getting stuck in a bent position that’s impossible to straighten.

Fortunately, in my case, I had caught it early and the solution was easy- wear weight-lifting gloves. This would prevent my hand from creating a tight fist and putting too much pressure on the tendon. 

But little did I know that just using the iPad hours a day would produce another cause for concern. Keeping the iPad secure for hours while I read or input data has put incredible stress on my thumbs. After just a few months they started to ache, then click and catch. At one point I actually had to decide which position to keep them in- up or down! That’s when I knew an intervention was needed.

Symptoms

• Finger stiffness, particularly in the morning
• A popping or clicking sensation as you move your finger
• Tenderness or a bump (nodule) in the palm at the base of the affected finger
• Finger catching or locking in a bent position, which suddenly pops straight
• Finger locked in a bent position, which you are unable to straighten

Trigger finger can affect any finger, including the thumb. More than one finger and both hands may be affected at the same time. Triggering is usually more pronounced in the morning, while firmly grasping an object or when straightening the finger.

Risk factors

• Repeated gripping. Occupations and hobbies that involve repetitive hand use and prolonged gripping may increase your risk of trigger finger.
• Certain health problems. People who have diabetes or rheumatoid arthritis are at higher risk of developing trigger finger.
• Your sex. Trigger finger is more common in women.
• Carpal tunnel syndrome surgery. Trigger finger may be a complication associated with surgery for carpal tunnel syndrome surgery, especially during the first six months after surgery.
• Your age. More common in ages 19 and older.

Treatment

Trigger finger treatment varies depending on its severity and duration.

Medications

Nonsteroidal anti-inflammatory drugs (NSAIDs) -such as ibuprofen (Advil, Motrin IB) or naproxen (Aleve) – may relieve the pain but are unlikely to relieve the swelling constricting the tendon sheath or trapping the tendon. And for many, their use is not recommended, always clear with your provider.

Therapy

• Rest. Avoid activities that require repetitive gripping, repeated grasping or the prolonged use of vibrating hand-held machinery until your symptoms improve. If avoidance is impossible, padded gloves may offer some protection.
• A splint. Wearing one at night to keep the affected finger in an extended position for up to six weeks may help rest the tendon.
• Stretching exercises. Gentle exercises may to help maintain mobility in the affected finger.

Surgical and other procedures

• Steroid injection. An injection of a steroid medication near or into the tendon sheath may reduce inflammation and allow the tendon to glide freely again. This is the most common treatment, and it’s usually effective for a year or more. It is most effective in most people treated in conjunction with lifestyle changes. But sometimes it takes more than one injection. This helped my thumbs. Even though researchers found that symptoms reoccur 12 months after the injection in 56 percent of affected digits, corticosteroid injection treatments are quick and simple and often puts off more invasive surgery. For people with diabetes, steroid injections tend to be less effective.
• Percutaneous release. After numbing your palm, a needle is inserted into the tissue around the affected tendon. Moving the needle and your finger helps break apart the constriction that’s blocking the smooth motion of the tendon.
• Surgery. Working through a small incision near the base of the finger, a surgeon can cut open the constricted section of tendon sheath.

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Those of us dealing with a trigger finger understand how intrusive and painful they can be. Talk to your provider and learn which option is best for you before it becomes debilitating.

-mayoclinic.org/diseases-conditions/trigger-finger/diagnosis-treatment/drc-20365148

-orthoinfo.aaos.org/en/diseases–conditions/trigger-finger

-my.clevelandclinic.org/health/diseases/7080-trigger-finger–trigger-thumb

-.ncbi.nlm.nih.gov/pubmed/18676896

-mdorthospecialists.com/blog/what-makes-women-more-susceptible-to-trigger-finger