Introduction
Trigger finger is a condition where pain, locking, and popping sensations occur in the finger when attempting to bend and straighten. If it occurs in the thumb, it is called trigger thumb.
The tendons (rope-like structures that attach muscles to bone) of our fingers normally glide smoothly through a small fibrous tunnel called the tendon sheath as you bend and straighten your fingers.
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When inflammation occurs, the swelling narrows the passage within the tendon sheath and it is difficult for the tendon to glide easily through the sheath. This can affect just one, or even multiple fingers.
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Signs and Symptoms
- Pain with finger movements
- Swelling
- Stiffness especially in the morning
- Nodules at the base of the finger or palm
- Finger is stuck in a bent position (severe)
- Snapping or popping sensations when attempting to straighten the fingers
Who Gets Trigger Finger?
People who are at risk are usually involved in activities or jobs requiring:
- Repetitive movements over prolonged periods (eg. typing, punching buttons)
- Forceful grasping and gripping movements (eg. holding scissors, screwdriver)
- Heavy lifting (eg. carrying grocery bags)
Other contributing factors are:
- Underlying health conditions (diabetes, gout, rheumatoid arthritis)
- Repetitive trauma
Commonly affected fingers follow this order:
- Ring finger
- Thumb
- Middle finger
- Index finger
- Pinky finger
Conservative Treatment
It is important to have the trigger finger treated at an early stage before the condition worsens.
- Avoid / reduce / modify the painful activities. If you are unable to avoid the aggravating, activities, ensure you have regular breaks in between, interspersing it with activities that place less stress on the hand.
- Splint to rest and immobilise the finger ( for 6 to 10 weeks)
- Nonsteroidal anti-inflammatory drugs (NSAIDs) for pain control and inflammation
- Corticosteroids injection
- Physiotherapy for active pain relief and recovery, strengthening and return to daily activities
From a local study, a combination of therapies (splint, topical NSAIDs, laser therapy, fluidotherapy and tendon gliding exercises) was effective in treating trigger finger and avoiding surgery in patients with mild to moderate symptoms (Choudhury et al. 2014).
Physiotherapy and Rehabilitation
Recovery Goals
- Pain reduction and inflammation control using modalities and massage
- Improve mobility and restore finger function with rehabilitative exercises such as tendon gliding exercises
- Lifestyle modification to minimise risk of recurrence of trigger finger
Be patient
Pain, locking, and popping sensations should reduce significantly with splinting which can take up to 10 weeks to feel better (Colbourn et al. 2008). But nodules may take months to go away. Nonetheless, be patient and continue to perform the daily rehabilitative exercises the physiotherapist has prescribed you to maximise recovery potential.
Surgical Intervention
If symptoms do not improve with conservative treatment and the condition is severe (fingers stuck in a bent position), elective surgical release can be an option. You may wish to discuss with your hand specialist for the treatment direction.