Trigger Finger and Trigger Thumb, or the technical name, Stenosing Tenosynovitis, are common hand conditions. This condition occurs basically when the tendons in the thumb and fingers do not glide smoothly. Trigger Finger or Trigger Thumb cause the tendons to get stuck when the fingers or thumb bend, making it difficult to straighten the fingers and thumb back out. Trigger finger can also cause pain, discomfort, swelling, and can occur in one or more fingers or the thumb at the same time, or it may occur in different fingers with or without thumb involvement at different times.
Finger and Thumb Anatomy
We have tendons that attach to our thumb and finger bones, and these tendons pass through a tunnel, called a tendon sheath, connecting to the muscles from our forearm. These muscles allow our fingers and thumb to straighten or extend.
Typically, the tendons glide smoothly through the tendon sheath. This allows for smooth and easy movements. However, tendons can have difficulty fitting through the tendon sheath if they are swollen or develop a nodule. The tendon sheath may also swell from general irritation, creating a smaller opening for the tendons to fit through. When the tendon gets stuck in the tendon sheath it can cause pain, swelling, and a popping or catching feeling. This means that the finger or thumb may get stuck in one position and will be difficult to bend or straighten.
Trigger Finger Causes
The definitive cause of Trigger Finger and Trigger Thumb is not always clear. We do know that the condition is more common among women than men and occurs most often in individuals between the ages of 40-60 years old. Trigger Finger and Trigger Thumb develop more frequently in people with certain medical conditions, such as:
- Rheumatoid Arthritis
- Autoimmune Disease
- some individuals may be born with a nodule on their tendon.
In some cases, repetitive gripping, such as holding tools, can cause the tendons to become irritated.
Trigger Finger Symptoms
The symptoms of Trigger Finger and Trigger Thumb usually start with pain and discomfort at the base of the finger or thumb. Some individuals feel pain in the palm of the hand. The area may be swollen and you may feel a small lump.
You will have difficulty bending and straightening your injured fingers or thumb. It may feel like the fingers catch or get stuck when you try to move them, this may be worse when you first wake up in the morning or after periods of inactivity. In more severe cases, the fingers or thumb can become stuck and unable to move.
Trigger Finger Diagnosis
A doctor can diagnose Trigger Finger or Trigger Thumb by simply examining your hand, in most cases. Your doctor will then feel for any clicking or popping during movement and note any restricted movement. A finger or thumb that is “locked” typically leads to diagnoses of Trigger Finger or Trigger Thumb.
Trigger Finger Treatment
For individuals with mild symptoms, rest and pain relief may relieve symptoms. The doctor may recommend that you wear a splint for support and may suggest over-the-counter pain medication to reduce discomfort and swelling. In some cases, doctors may choose to inject an anti-inflammatory cortisone medication into the site.
Trigger Finger Surgery
Surgery is only recommended when other treatments have failed or if the thumb or finger is stuck in a bent position. There are a couple of surgical options for trigger finger:
- In the outpatient based surgery, your surgeon will numb the area and make a small opening on the palm side of your hand. The surgeon will then make an incision in the tendon sheath. This creates a larger tunnel for the tendons to fit through and enable them to glide easily.
- In some cases, the tendon sheath can be safely opened with the tip of a needle. This will also create a larger tunnel for your tendons to move through with ease, and can be performed from the comfort of your doctor’s office.
Trigger Finger Recovery
Trigger Finger recovery is dependent on the extent of the condition and the type of surgery performed, if any was necessary. You will be able to move your fingers or thumb immediately after surgery. However, you may experience discomfort or swelling for a short period of time. Some individuals may require hand therapy to help regain movement, but most people achieve a full recovery in just a few weeks.