Trigger Finger: That Annoying Stuck Finger

Trigger finger is a common reason for a trip to a primary doctor’s office. 

Patients will come in with one of their fingers (most often the ring finger or one of the other long digits) noting a catching or locking sensation with pain when opening and sometimes even stating the need to use the other hand to pry open the finger to get it back into a straightened position.  So what exactly causes the finger to get locked down against the palm and feel stuck?  

(Image: Georg Bommeli/Unsplash)

First lets talk about the anatomy of the hand. 

This is actually very complex.  Surgeons spend years and years specializing in only the hand in order to treat and operate on it.  But to simplify we will review the basic structures involved when someone develops a trigger finger.  First there are the tendons.  Tendons are made of fibrous tissue and connect muscle to bone and are involved in movement of the digit.  Tendons each have a covering to help them move smoothly and keep them close to the bone and this covering is called a “tendon sheath.”  If the tendon sheath becomes inflamed or thickened it does not allow for the tendon to glide easily through it the involved finger will become locked in place creating a trigger finger.

(Image: Jorge Rojas/Unsplash)

Why does the tendon sheath become thickened or inflamed? 

As mentioned trigger finger is a common condition in primary care and orthopedic offices.  Approximately 2-3% of the population will experience a trigger finger, however, the underlying cause is not completely understood.  We do know that there are some people who are at higher risk for developing the condition.  Trigger finger is more common in women especially in women ages 40-50’s.  People who do repetitive work with their hands are more at risk, as are those with underlying health conditions such as rheumatoid arthritis and diabetes where the incidence increases up to 10%. The condition is also increased during pregnancy and in those who have had recent hand surgery for other conditions.  

Can I do anything to prevent trigger finger? 

Because overuse of the digits is known to be one of the greatest risk factors, if you work with your hands repetitively, be sure to take breaks so as to allow the hands to rest and recuperate.

(Image: Swapnil Dwivedi/Unsplash)

How to treat the trigger finger? 

First line treatment for trigger finger will be rest of the affected digit.  Your physician will also recommend a finger splint that immobilizes the involved tendon sheath for you to wear nightly for several weeks.  For the discomfort and inflammation medications in the NSAID class are often recommended (ibuprofen, naproxen, etc).  Should these measures not improve symptoms, an injection of a steroid medication might be administered to the affected area.  Finally, if all of the above still does not result in resolution, referral to a hand specialist will be made for surgical treatment of the trigger finger.  

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