Trigger finger, medically known as stenosing tenosynovitis, is a condition in the hand characterized by stiffness, pain, and the locking of the finger. The name stems from the manner in which the finger locks in a bent position, giving the appearance of the finger pulling a trigger.
Flexor tendons connecting the forearm to the end of the fingers are responsible for allowing the fingers to move. When everything functions correctly, the tendons glide through protective coverings known as sheaths. When inflammation occurs inside or outside of the sheath, friction builds, and the optimal gliding motion of the tendons is restricted, resulting in trigger finger.
The ring finger and thumb are the most common fingers affected by the condition, but any finger can be affected. The first sign of trigger finger is stiffness, which typically begins as a dull sensation near the base of the finger. When left untreated, this tension worsens, leading to increased discomfort and the locking of the fingers.
A popping or clicking noise will often accompany finger movement, and this sensation is heightened when the fingers have been sedentary for a prolonged period. For this reason, symptoms are usually worse in the morning. In some cases, fluid buildup can lead to a small lump near the base.
Many times, the root cause of trigger finger cannot be determined, though hobbies and jobs that require intense hand usage and gripping are sometimes linked to the condition.
Certain groups are more at risk for trigger finger, including women, adults over the age of 50, and those diagnosed with diabetes, thyroid disease, and Rheumatoid arthritis. Trigger finger is extremely rare in children.
There is no proven way to avoid trigger finger, though taking preventative measures can reduce your chances of suffering from the condition. Those who perform jobs or partake in activities that require heavy utilization of the fingers should incorporate breaks and implement routine stretching. Seeking medical feedback before symptoms worsen can also lessen the severity of the condition.
Non-surgical
One of the best ways to ease trigger finger symptoms is taking a nonsteroidal anti-inflammatory such as ibuprofen, Advil, or naproxen. It’s best to take the medication twice daily for two weeks to see if symptoms improve before re-evaluating the condition.
When anti-inflammatories aren’t providing relief, and symptoms are severe, a steroid injection is typically the next treatment option to consider. The steroid is injected into the tendon sheath to reduce inflammation. Pain is often reduced within several hours, and a successful injection should improve irritation and swelling within two weeks. Oftentimes, injections are not a permanent solution, though they can be effective for a year or more.
Splinting the affected finger is another non-surgical option that has proven effective in many patients. The splint limits finger flexion while allowing it to glide more stably. Nighttime is usually the best time for splinting since finger movement is minimal.
Exercises
Many simple exercises can aid in managing your trigger finger symptoms. The best time to perform them is after the hands have been in a sedentary position for a prolonged period. For this reason, it’s wise to implement your routine shortly after waking up.
Hand clenches are a simple yet effective way to treat symptoms. The exercise starts by clenching the hand in a fist, holding it for 2-3 seconds, then straightening the fingers. Ten repetitions are an ideal target for the exercise.
The finger extensor stretch is another recommended way to loosen the stiff area. To begin, rest the affected hand on a flat surface, then use the other hand to slowly raise the symptomatic finger while keeping the rest of the fingers flat. The finger should be lifted as far as it will allow without noticeable pain, then held for 2-3 seconds before being lowered back to the starting position. It is best to perform at least five repetitions and repeat three times daily for as long as symptoms persist.
Physical Therapy
Physical therapy is one of the best ways treatment options to manage trigger finger symptoms and promote healing. Not only is it an effective treatment on its own, but it’s also an important part of recovery when surgery is required.
Scheduling a consultation at Hicksville Physical Therapy will allow us to better understand the severity of your symptoms and design the right plan for restoring your finger health. A simple examination with our staff is usually sufficient to provide an official diagnosis.
Depending on the severity of the condition, our team will start you on a stretch and exercise program that can be implemented at home. We will take you through each movement and then have you repeat it to ensure you understand how to do it properly. We may also prescribe resting when possible until there is a clear sign of improvement.
Heat treatment and soft tissue massages are additional methods we can incorporate on-site to ease pain and discomfort while working your fingers back to their full range of motion.
The length of your physical therapy program will vary based on results. Hicksville Physical Therapy has conducted many programs ranging from 4-12 weeks that have made a tremendous difference in restoring the finger health of Nassau County residents.
Surgery
Surgery is the last resort for treating trigger finger and should only be sought after non-surgical methods have been deemed unsuccessful or in extreme cases where a bent finger cannot be straightened.
Trigger finger surgery is an outpatient procedure, with anesthesia used to numb the hand. The goal of the surgery is to get the tendon moving normally again. In order to do this, a small incision is made in the palm area, and the sheath is widened so the tendon can move freely as it’s intended to do.
Recovery time for surgery can range from a few weeks to a few months, but pain and clicking of the finger should subside quickly. Swelling and some level of stiffness may occur post-surgery, in which case, physical therapy will assist in getting your finger back to full strength.
For more information about trigger finger treatment options in Long Island, contact Hicksville Physical Therapy today.
