What is trigger finger?
The tendon passes through a series of pulleys that hold it close to the bone, a little like a fishing rod, and anything that reduces the space in the pulleys can cause “catching” or “clicking” when bending the finger. As the condition progresses the finger may “lock” in a bent position and straighten with a snap or may need to be straightened manually.
What causes trigger finger?
Trigger finger develops when the tendon sheath of a finger becomes inflamed and irritated. The tendon attaches the muscle to the bone, and the sheath protects the tendon and allows it to glide smoothly. The inflammation caused by trigger finger disrupts the tendon's gliding motion as it moves through the sheath.
Irritation of the tendon sheath over a long period can lead to the tendon thickening, nodules (bumps) forming, and scarring. These developments contribute to further interruption of the tendon's movement.
Trigger finger is more common with some health problems such as rheumatoid arthritis or diabetes, it is also more common in women.
Symptoms of trigger finger
The symptoms of trigger finger are a “clicking” sensation when bending the finger, stiffness in the digit. Early in the condition there may only be tenderness or a slight bump in the palm at the base of the finger. In general, the stiffness and 'triggering' is more prominent in the morning, especially when trying to grip an object or straighten the finger.
Treatment options for trigger finger
Non-surgical treatment options will be recommended initially, these include; avoiding actions which cause the triggering, use of a splint, which can be worn at night to keep the finger in an extended position, while resting the tendon; and stretching exercises, which can promote mobility in the affected finger.
A steroid injection around the pulley may help to reduce inflammation and encourage the free movement of the tendon. This is a common treatment which typically provides good initial relief, but may need to be repeated.
Surgery is undertaken with a skin numbing injection and a small cut is made near the finger base, the pulley causing the constriction is released, allowing the tendon to glide smoothly.
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