Trigger finger / trigger thumb

What is trigger finger and trigger thumb? 

Trigger finger is a condition affecting flexors tendons of  fingers or thumb. Bending and straightening of the finger or thumb is difficult and it feels like the finger is stuck or locked and needs to be forced open. The triggering or forced opening is often accompanied with clicking sound and pain. 

Trigger finger happens when the tendons responsible for bending the finger (flexors tendons) get inflamed and thickened. The affected tendon can't glide through the pulley mechanism that keeps the tendon close to the bones and joints in the finger preventing the tendon from bowing. 

The mechanism of the trigger finger is nicely explained in the video across.

 

What are the symptoms and what is the cause of the trigger finger? 

Trigger finger usually affects women and is more common in older age. Ring finger and thumb are the 2 most commonly affected fingers. The symptoms include:

  • catching, locking or popping when bending and straightening the finger
  • tender lump in the palm just below the affected finger
  • stiffness of the finger
  • finger can be stuck in bent position
  • pain when moving the finger

Usually  the trigger finger comes on without obvious cause but some activities like gripping for prolonged time or gripping forcefully repeatedly can contribute to developing this condition. It is quite common amongst farmers, musicians or factory workers. It is also more common in people with diabetes and rheumatoid arthritis. 

There is also a condition called Paediatric Trigger Thumb. It affects babies and children before the age of 5 and the main symptom is the tip of the thumb being stuck in flexion (bent in).  This is usually fixed by splinting or stretching but sometimes a simple surgery procedure will resolve the problem. It is however very important to have it sorted because if left untreated the other joints in the thumb will get overloaded as they compensate for the fault in the tip and the child can end up with joint issues later on in life.

 

What is the treatment for trigger finger?

Treatment for trigger finger or trigger thumb depends on severity of the condition. Full recovery is usually achieved. 

  • rest and splinting - if the trigger finger or trigger thumb are quite mild and the movement in the finger is still possible
  • steroid injection - together with the splinting and rest to ease the swelling, inflammation and pain
  • physiotherapy - gentle exercises and soft tissue work/ massage of the affected tendon
  • surgery - if the above treatments didn't work and the condition is causing pain and functional limitations or if the finger is permanently bent and can not be open with gentle pressure

 

In the Perfect Therapy clinic we see clients for both conservative (no-surgical) treatment and for rehabilitation after the surgery. The treatment would usually include: 

  • hydrotherapy - to reduce inflammation, swelling and pain
  • splinting -  to support the finger during activities requiring movement of the fingers as well as light night splinting to prevent the finger from bending into the palm
  • soft tissue work - gentle manipulation of the affected tissue, massage and instrument assisted massage 
  • exercise program - to maintain the range of movement in the finger and hand
  • ultrasound - to reduce swelling and inflammation