Despite the old west movies about a gunslinger having an “Itchy” one, Trigger Finger is a bona fide medical condition, where one of your fingers becomes stuck or trapped in a contracted or bent position. Some people who experience a trigger finger find that the affected finger will straighten or bend with a dramatic snapping motion. This replicates the rapid motion of pulling the trigger on a firearm, which gives the condition its laymen’s name.
Stenosing Tenosynovitis is the technical term for Trigger Finger. It is typically related to localized inflammation that essentially narrows the space in the sheath that surrounds the tendon in the affected finger. In some severe cases, the affected finger might become locked in the bent position. Attempting to force it straight could injure the tendon and other surrounding connective tissues leading to more severe complications.
What Causes Trigger Finger?
Trigger finger (Stenosing Tenosynovitis) can be caused by certain lifestyle activities and can be a symptom associated with other medical conditions.
Individuals whose career or hobby requires a repetitive gripping motion are naturally going to be at higher risk of experiencing some degree of Trigger Finger. It is also more common in women as well as individuals with diabetes or chronic inflammatory conditions that affect the hands.
What Are The Symptoms Of Trigger Finger?
While a finger that’s locked in a bent position is a salient, and obvious symptom of trigger finger, there are other symptoms and possible early indicators to be mindful of. If you are experiencing any of the following symptoms of Stenosing Tenosynovitis, you might want to consider scheduling an appointment with your physician.
- Finger stiffness is worse in the morning and gradually improves throughout the day.
- A recurring clicking sensation localized to a specific finger.
- A popping sensation in a finger when moving it from bent to straight.
- A bump, known as a nodule in the palm of your hand near the base of the symptomatic finger.
- Tenderness near the base of a finger near the palm or near a recently developed nodule.
- A specific finger locking or becoming trapped in a bent position
- A finger that catches and then suddenly pops straight again.
- A specific finger that becomes locked in a bent position and cannot be straightened again.
It’s also worth noting that Stenosing Tenosynovitis can affect any finger on either hand. Including both of your thumbs. It’s also possible for Trigger Finger to affect more than one finger at a time, and both can also affect fingers on both of your hands at the same time.
Triggering is usually more pronounced in the morning, while firmly grasping an object or when straightening your finger.
Why Is Trigger Finger Worse In The Morning?
People who are developing Stenosing Tenosynovitis often notice one or more fingers locking or catching in place in the middle of the night or first thing in the morning. This is usually related to the hands being held in a slightly contracted position for several hours at a time while you are sleeping. This can allow inflammation to build up in the finger’s connective tissues, causing them to tighten. Gradual motion and improved blood flow when you move your hands in the morning help to loosen the connective tissues allowing you to move your fingers somewhat normally again after an hour or so in the morning.
Most people who notice one or more fingers locking up will experience Trigger Finger symptoms worsening over time. Morning after morning you might notice that the affected finger takes longer to free itself from the locked position, or that symptoms like clicking, popping and tenderness are getting worse.
Trigger Finger Risk Factors
Several factors can increase your risk of developing Trigger Finger in one or more fingers. This includes:
- A job or hobby that requires repeated gripping, or holding your grip for extended periods of time.
- Diabetes increases inflammation complications.
- Rheumatoid arthritis and the resulting inflammation also heightens your risk of developing trigger finger.
- Women are also more likely to develop trigger finger than men.
- Carpal tunnel sufferers who require surgical intervention might experience trigger finger as a postoperative complication.
Trigger Finger Explained
Tendons are essentially fibrous cords that serve to attach a muscle to the surrounding bones to help move the bone and all its connected structures. Every tendon has a protective sheath that surrounds it. Inflammation affects a finger’s tendon sheath with the naturally smooth gliding motion of the tendon through the sheath. This causes the finger to catch or lock-in position.
As time goes on inflammation can cause scarring in the protective tendon sheath. This causes it to thicken and can lead to nodule “Bumps” that further impede the tendon’s natural motion. This is why many people find their trigger finger symptoms worsen over time.
When Should I See A Doctor About Trigger Finger?
If you have noticed worsening symptoms of trigger finger such as stiffness, catching, numbness, or pain in a finger joint, or if you can’t straighten or bend a finger, you should contact your primary care physician.
You need to see immediate medical attention if the affected finger joint is severely inflamed and/or it feels “Hot.” This could indicate that a serious infection has started to develop in the affected joint or the surrounded connective tissues.
How Is Trigger Finger Treated?
Treatment for trigger fingers can vary depending on severity as well as the number of fingers it affects.
Trigger Finger Therapy
For a mild to moderate case of trigger finger, treatment might start with rest and physical therapy. This might include activity cessation. This might include wearing padded gloves when operating machinery that requires gripping.
Your physician might also provide you with a series of gentle exercises and hand stretches you can perform on a daily basis to help maintain your mobility.
In some cases, your physician might also provide you with a splint that you can wear on the affected hand when you sleep. This will keep the affected finger in an extended position to keep it from locking or catching in the bent position. Your physician will then monitor your progress over the course of six to eight weeks.
Medications For Trigger Finger
If other medical conditions cause recurring inflammation issues, your physician might advise you to take over-the-counter anti-inflammatory medication or might provide you with a prescription for a stronger anti-inflammatory medication.
Steroid injections placed into the tendon sheath may reduce inflammation and allow the tendon to glide freely again. This treatment method usually calls for multiple injections over the course of a year, rather than a one-time injection for short-term relief.
Surgery For Trigger Finger
If non-invasive trigger finger treatments fail to improve your symptoms, your physician might recommend surgical intervention.
Percutaneous release is the most common and most effective surgical treatment for trigger finger. It can be performed on an outpatient basis, where the physician numbs your hand with a local anesthetic. The physician inserts a sturdy needle into the tissue around your affected tendon to help release the constriction that’s blocking the naturally smooth motion of the tendon.