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Trigger Finger

Dec 31, 2014

Trigger Finger - what actually is that?  Well despite it's name, it is nothing to do with actual guns, and a lot to do with pain in the tendons in the fingers. Trigger Finger is a more user friendly name used to encompass the medical condition referred to as stenosing tendovaginitis or tenosynovitis.

So What Is Trigger Finger?

It is basically a condition in which one of your fingers gets stuck in a bent position. Your finger may straighten with a snap — like a trigger being pulled and released - which is where its's common name comes from. The condition usually occurs when severe inflammation narrows the space within the sheath that surrounds the tendon in the affected finger. If the trigger finger condition is severe, your finger may become locked in a bent position which can be incredibly painful for the patient.

People whose work or hobbies require repetitive gripping actions are at higher risk of developing trigger finger. The condition is also more common in women and in anyone with diabetes. Treatment of trigger finger varies depending on the severity.

How Would You Know If You Were Suffering From Trigger Finger
Signs and symptoms of trigger finger may progress from mild to severe and can include, but are not limited to:

- A Feeling of stiffness in the finger, 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

In most cases, Trigger Finger will affects the patients thumber or middle or ring fingers. In some cases, more than one finger may be affected at the same time, and if you are really unlucky, it could affect both hands.

The pain and difficulty in bending the affected area - known as "triggering" - is more common in the morning, or when grasping an object or straightening the fingers.

In some early cases, the patient notices nothing more than a slowness in bending or moving the finger, or a weakness in the finger.

So, What Causes It?


Most cases occur for no apparent reason, and usually in very healthy people. Around 2 in 100 people develop trigger finger. For some unknown reason, it is more common if you are aged over 40 and if you are female

In can occur after you have used your palm a lot. For example, after jobs which involved a lot of screwdriver use or working with tools that press on the palm. These may cause some inflammation in the palm which can lead to tendon pain.

Sometimes trigger finger occurs as a feature of another disease. For example, trigger finger is more common in people with rheumatoid arthritis, amyloidosis, diabetes, carpal tunnel syndrome and in people on dialysis. In these situations you will have other symptoms of the condition and the trigger finger is just one feature.

Diagram of the hand showing trigger finger

 

What Are My Treatment Options

Well, in the first instance you may not need any treatment. Around one in five people will improve without any treatment. Simply resting the hand and allowing any inflammation medication to settle may resolve the problem without the need for treatment. You may be advised to take some anti-inflammatory medicines (for example, ibuprofen), which can be purchased over the counter.

Splinting

Your symptoms may improve if your finger (or thumb) is strapped to a plastic splint so that it is completely straight. Some people wear a splint just at night. Stopping the finger moving can ease symptoms in some patients. Your GP would be able to advise you how long you would need to wear the splint for in order for it be successful.

A steroid injection

Corticosteroids are medicines that can be used to reduce swelling. In cases of trigger finger, liquid corticosteroids are injected into the tendon sheath (the tunnel that the tendon slides through), at the base of your affected finger or thumb. These are thought to work because they reduce swelling of the tendon, allowing the tendon to move freely again. This can sometimes happen within a few days of having the injection, but it usually takes a few weeks.

Corticosteroids are medicines that can be used to reduce swelling. In cases of trigger finger, liquid corticosteroids are injected into the tendon sheath (the tunnel that the tendon slides through), at the base of your affected finger or thumb. Corticosteroids are thought to work because they reduce swelling of the tendon, allowing the tendon to move freely again. This can sometimes happen within a few days of having the injection, but it usually takes a few weeks.

A corticosteroid injection can permanently improve trigger finger, but it doesn't work straight away for all cases. You can have a second injection if the effect wears off, but this is generally less effective than the first injection. Corticosteroid injections are estimated to be an effective treatment for 50–80% of people with trigger finger. However, they are generally less effective in people with certain underlying health conditions, such as diabetes and rheumatoid arthritis.

Surgery

Surgery is the ultimate way to remove Trigger Finger permanently. An operation is done under local anaesthetic where a small cut is usually made at the base of the finger and the tendon sheath is widened. The operation is usually very successful.

An alternative operation is a percutaneous trigger finger release. A needle is used to release the tight mouth of the tunnel so an open operation is avoided. However, with an operation there is a small risk of damaging the tiny finger nerve and causing some numbness to the finger. Also, as with any operation, there is a small risk of any wound becoming infected

After the operation, the hand is placed in a bulky dressing with the fingers free. When the dressing is removed, additional hand therapy may be useful.

At Austingraces we offer treatment for Trigger Finger and work alongside the patient to ensure that their journey to pain free fingers is as straightforward as possible. Call us on 08456 020621 to find out more.

 

 



Category: Medical Treatment