Trigger Finger & Trigger Thumb
Overview:
Trigger finger and trigger thumb, also known as stenosing tenosynovitis, are conditions that affect the tendons in the fingers or thumb, causing them to become inflamed and causing pain and stiffness.
In normal hand function, the tendons that run through the fingers and thumb slide smoothly through a sheath, allowing the fingers and thumb to move easily. However, with trigger finger or thumb, the tendons become irritated, causing them to thicken and making it difficult for them to move through the sheath.
This can cause the finger or thumb to "catch" or "lock" in a bent position, making it difficult or even impossible to straighten without using the other hand. In some cases, a popping or clicking sensation may also be felt when attempting to move the affected finger or thumb.
Trigger finger and trigger thumb are most common in people who perform repetitive gripping or grasping motions, such as those who work with tools or play musical instruments. Women, people with diabetes, and those with other medical conditions such as rheumatoid arthritis may also be at higher risk for developing trigger finger or thumb.
Treatment options include rest, splinting, anti-inflammatory medication, and in more severe cases, corticosteroid injections or surgery.
What is trigger finger and trigger thumb?
Trigger finger and trigger thumb, also known as stenosing tenosynovitis, are conditions that affect the tendons in the fingers or thumb. The tendons in our fingers and thumb connect the muscles in the forearm to the bones in the fingers and thumb, allowing us to move them.
In trigger finger or thumb, the affected tendon becomes inflamed, making it difficult for it to move through the sheath that surrounds it. This can cause the finger or thumb to "catch" or "lock" in a bent position, making it difficult or even impossible to straighten without using the other hand. In some cases, a popping or clicking sensation may also be felt when attempting to move the affected finger or thumb.
The exact cause of trigger finger or thumb is not always clear, but it is most commonly associated with repetitive gripping or grasping motions, such as those used in tools or musical instruments. It may also be associated with other medical conditions, such as diabetes, rheumatoid arthritis, or gout.
Treatment options for trigger finger or thumb depend on the severity of the condition. Rest, splinting, anti-inflammatory medication, and in more severe cases, corticosteroid injections or surgery may be recommended.
Who gets trigger finger or trigger thumb?
Trigger finger or trigger thumb can occur in anyone, but it is more common in certain groups of people. Some factors that may increase the risk of developing trigger finger or thumb include:
● Age:
The condition is more common in people over the age of 40.
● Gender:
Women are more likely to develop trigger finger or thumb than men.
● Occupation:
Jobs that require repetitive gripping or grasping motions, such as construction work or playing musical instruments, may increase the risk of developing trigger finger or thumb.
● Medical conditions:
People with certain medical conditions, such as diabetes, rheumatoid arthritis, gout, or hypothyroidism, may be more prone to developing trigger finger or thumb.
● Genetics:
There may be a genetic component to trigger finger or thumb, as it may run in families.
If you think you may be at risk for trigger finger or thumb, it is important to speak with a healthcare professional. They can help you understand your risk factors and provide guidance on how to prevent or manage the condition.
What causes the finger(s) or thumb to remain bent?
Trigger finger or trigger thumb causes the finger or thumb to remain bent or locked in a flexed position because the affected tendon is inflamed and cannot move smoothly through its sheath.
Normally, tendons slide easily through a narrow tunnel or sheath in the finger or thumb as the muscles in the forearm contract and relax. However, when the tendon becomes inflamed or thickened, it can get stuck as it moves through the sheath, causing the finger or thumb to remain bent or locked in a flexed position.
As the finger or thumb is straightened, the thickened and inflamed tendon may catch on the edge of the sheath, causing a sensation of snapping or popping. This can be painful and can further irritate the tendon, exacerbating the condition.
In more severe cases, the tendon can become permanently stuck in a bent position, making it difficult or impossible to straighten the finger or thumb without medical intervention. This is why it is important to seek medical attention if you suspect you may have trigger finger or thumb.
What are the signs and symptoms of trigger finger or trigger thumb?
The signs and symptoms of trigger finger or trigger thumb can vary in severity and may include:
■ Pain or discomfort in the affected finger or thumb, especially when bending or straightening it.
■ Stiffness in the affected finger or thumb, especially in the morning or after periods of rest.
■ A popping or clicking sensation when moving the affected finger or thumb.
■ A bump or nodule at the base of the affected finger or thumb.
■ The finger or thumb may become stuck in a bent or flexed position, requiring the use of the other hand to straighten it.
■ A feeling of weakness or a loss of grip strength in the affected finger or thumb.
■ In more severe cases, the affected finger or thumb may remain stuck in a bent or flexed position, making it difficult or impossible to straighten without medical intervention.
If you are experiencing any of these symptoms, it is important to speak with a healthcare professional to determine the underlying cause and receive appropriate treatment.
Trigger Finger Diagnosis
The diagnosis of trigger finger or trigger thumb is typically based on a physical examination by a healthcare professional, as well as a review of your medical history and symptoms.
During the physical examination, the healthcare professional may ask you to bend and straighten the affected finger or thumb to assess its range of motion and any clicking or popping sensations. They may also palpate the area around the affected tendon to check for the presence of a bump or nodule.
In some cases, imaging tests such as an X-ray or MRI may be ordered to rule out other conditions, such as arthritis or a fracture.
It is important to seek medical attention if you are experiencing symptoms of trigger finger or thumb, as early diagnosis and treatment can help prevent further damage to the affected tendon and improve outcomes.
Is surgery an option?
Yes, in some cases, surgery may be an option for the treatment of trigger finger or trigger thumb.
Surgery is typically recommended if other treatments, such as rest, splinting, anti-inflammatory medication, and corticosteroid injections, have been unsuccessful in relieving symptoms. It may also be recommended if the affected finger or thumb is permanently stuck in a bent position, making it difficult or impossible to straighten.
During the surgery, the sheath that surrounds the affected tendon is opened or widened, allowing the tendon to move more freely through it. The surgery is typically done under local anesthesia, and the recovery time is usually a few weeks.
While surgery is generally considered safe and effective, like any medical procedure, it does carry some risks. These can include bleeding, infection, nerve damage, and recurrence of symptoms.
Your healthcare professional can help you determine if surgery is the right treatment option for your specific case and can provide guidance on what to expect before, during, and after the procedure.
How are trigger finger or trigger thumb treated?
The treatment of trigger finger or trigger thumb depends on the severity of the symptoms and the underlying cause of the condition. In many cases, non-surgical treatments are effective in relieving symptoms.
These may include:
● Resting the affected finger or thumb:
Resting the finger or thumb and avoiding activities that aggravate symptoms can help reduce inflammation and allow the affected tendon to heal.
● Splinting:
Wearing a splint or brace to immobilize the affected finger or thumb may help reduce inflammation and allow the tendon to heal.
● Anti-inflammatory medication:
Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen can help reduce inflammation and relieve pain.
● Corticosteroid injections:
Injecting a corticosteroid medication into the affected area can help reduce inflammation and relieve pain.
● Hand therapy:
Stretching and strengthening exercises under the guidance of a physical therapist can help improve range of motion and reduce symptoms.
In more severe cases or when non-surgical treatments are ineffective, surgery may be necessary. During surgery, the sheath around the affected tendon is opened or widened, allowing the tendon to move more freely.
It is important to seek medical attention if you suspect you may have trigger finger or thumb, as early treatment can help prevent further damage to the affected tendon and improve outcomes.
What are the complications and related diseases of trigger finger?
While trigger finger or trigger thumb is usually a benign condition that can be effectively treated with non-surgical methods, there are some complications and related diseases that may be associated with the condition.
These may include:
■ Recurrence of symptoms:
In some cases, trigger finger or thumb symptoms may recur, even after successful treatment.
■ Stiffness and decreased range of motion:
Without treatment, the affected finger or thumb may become permanently stiff and difficult to move.
■ Dupuytren's contracture:
This condition causes the connective tissue in the palm of the hand to thicken, resulting in one or more fingers becoming permanently bent.
■ Rheumatoid arthritis:
This chronic autoimmune disease can cause inflammation in the joints, including those in the hands and fingers.
■ Diabetes:
People with diabetes may be at an increased risk of developing trigger finger or thumb, and they may be more likely to experience complications related to the condition.
■ Carpal tunnel syndrome:
This condition causes compression of the median nerve in the wrist, resulting in pain, numbness, and weakness in the hand and fingers.
■ Tendinitis:
Inflammation of the tendons in the hand and fingers can cause pain, stiffness, and decreased range of motion.
It is important to seek medical attention if you suspect you may have trigger finger or thumb to prevent the development of complications and related diseases.
Can trigger finger be prevented?
While there is no surefire way to prevent trigger finger or trigger thumb, there are steps that you can take to reduce your risk of developing the condition or to minimize symptoms if you have already been diagnosed.
Some preventative measures include:
● Take breaks:
If you perform repetitive hand motions, take frequent breaks to rest your hands and fingers.
● Stretch and exercise:
Perform hand and finger stretches and exercises regularly to keep your tendons and muscles flexible and strong.
● Maintain a healthy weight:
Being overweight can increase your risk of developing trigger finger or thumb, as well as other joint-related conditions.
● Use proper hand positioning:
Avoid bending or flexing your fingers for prolonged periods, and use proper hand positioning when performing tasks such as typing or using a computer mouse.
● Avoid excessive force:
Avoid using excessive force when gripping objects, as this can increase your risk of developing trigger finger or thumb.
While these preventative measures may help reduce your risk of developing trigger finger or thumb, it is important to remember that the condition can occur for various reasons and may not always be preventable. If you are experiencing symptoms of trigger finger or thumb, it is important to seek medical attention to prevent further damage and improve outcomes.
Trigger finger in children
Trigger finger can occur in children, although it is less common than in adults. In children, trigger finger is most commonly seen in those between the ages of one and four years old, and it is more common in boys than in girls.
The causes of trigger finger in children are not entirely clear, but it is believed to be related to a developmental abnormality in the tendons or the tendon sheath. In some cases, it may also be related to underlying medical conditions, such as diabetes or rheumatoid arthritis.
The symptoms of trigger finger in children are similar to those in adults, including pain, stiffness, and a popping or clicking sensation when moving the affected finger. Children may also experience difficulty straightening or bending the affected finger.
Treatment for trigger finger in children is similar to that in adults and may include rest, splinting, anti-inflammatory medication, and corticosteroid injections. In severe cases, surgery may be necessary.
If you suspect that your child may have trigger finger, it is important to seek medical attention from a healthcare professional who has experience in treating pediatric hand conditions. Early diagnosis and treatment can help prevent further damage and improve outcomes.
