What is a trigger finger or trigger thumb?
Trigger finger is when your fingers or thumb can’t move easily. They may stay bent and not straighten. It happens because of the restricted movement of the tendons in your fingers and thumbs. Trigger finger is named after the way your fingers can look like you’re squeezing a trigger.
Your fingers or thumb may stay bent toward your palm if you have trigger finger. It may be very hard or not possible to make them straight. Trigger finger can happen in any of your fingers or thumb, but it is more common in your ring finger (the third one).
What is the cause of trigger finger?
Tendons are tissues that connect muscles to bones. They work with muscles in your hands to bend and straighten your fingers and thumb. A tissue tunnel called a sheath covers these tendons. The sheath guards them and holds the tendons in place.
Trigger finger occurs when the tendons in your fingers or thumb get inflamed and swollen. They can’t slide smoothly through their sheaths. A lump (nodule) may grow on your tendon, which makes sliding harder.
The nodule often catches or gets stuck on a specific part of the tendon, which is called A1 pulley. If your tendon can’t slide well through the A1 pulley, your finger will feel tight or jammed.
What are the Risk factors of Trigger finger?
Trigger finger can affect anyone, but it is more common in people from 40 to 60 years old.
You can get trigger finger if you do a lot of hard work, repeated movements, holding, squeezing, or pushing with your fingers and thumbs. Some examples are: Garden workers, doing industrial work or using tools, playing musical instruments, playing sports with rackets (like tennis, badminton etc.).
Some health problems can also make you more prone to trigger finger, such as: Osteoarthritis. Rheumatoid arthritis, Gout, Diabetes, Amyloidosis or Thyroid disease.
What are trigger finger symptoms?
Some common signs of trigger finger are:
A cracking or clicking sound when you move your fingers or thumb.
Your fingers or thumb may feel like they are snagging or jamming as they move.
Pain and tightness when bending your fingers or thumb toward your palm. Aching in your palm near where your fingers or thumb start. This ache is often worse when you hold or squeeze something.
A swollen or sore bump in the palm of your hand.
Your fingers or thumb staying bent and not straightening. You may have to use your other hand to gently make your fingers straight.
Trigger finger symptoms (like stiffness and bent positions) are usually worse in the morning. Symptoms may improve a bit as you use your fingers and thumb.
How is the diagnosis of trigger finger made?
A history and physical examination are sufficient for establishing the diagnosis. Most of the time, pain physicians wont advice any extra tests, though an ultrasound examination will provide additional information.
How is trigger finger treated?
Some common ways to treat trigger finger are:
Rest: Stop doing the things that made your trigger finger worse. This will let your tendons heal.
Splinting: You may have to wear a splint to keep your fingers or thumb still and help them get back to normal.
Stretching exercises: Your provider may show you some exercises to make your tendons more flexible.
Anti-inflammatory medication: You can take over-the-counter pain killers drugs like diclofenac or ibuprofen to ease pain and swelling 9for a very short term only).
Pain Intervention: Injection of small dose of corticosteroids around the tenson under ultrasound guidance is highly effective treatment.
Dr. Chinmoy Roy is a senior well-known pain specialist and author of multiple medical books who is available at Rajarhat Pain Clinic, Newtown, Kolkata. He is an expert of using radiofrequency, CRYO, chemical neurolytics and ultrasound or X-ray guided pain procedures.
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