Trigger finger-All you need to know

Trigger finger is one of the most common causes of hand pain in adults. The condition can limit your finger’s movement and make it difficult to straighten and bend your finger.

Why is it named trigger finger?

Trigger finger, also known as stenosing tenosynovitis, is a condition where you experience pain and swelling at the base of the finger. Any finger, and more than one finger, can be affected by this condition. When you extend the affected finger from a clenched position, it may jerk, snap or click – much like the trigger of a gun when initiating fire. This is why it is named trigger finger.

What are the symptoms?

The first symptoms of trigger finger tend to be pain and a slight thickening at the base of the affected finger or thumb. The characteristic snapping sensation can start suddenly, or develop gradually. Pain may be felt toward the end of the finger or thumb or in the palm. You may find that the finger or thumb is locked toward the palm when you wake up and gradually releases over the course of the day.

It may seem like the problem is related to the middle knuckle of the finger or the top knuckle of the thumb. But it’s actually arising from the base of the affected digit. Sometimes you can release a locked digit by massaging it at its base.

What causes the finger(s) or thumb to remain bent?

Tendons are bands of tissue that attach muscles to bones. In the hand, tendons and muscles must work together to flex and straighten your fingers and thumb. Usually, tendons slide easily through a tunnel of tissue called a sheath. The sheath keeps the tendons in place next to the bones of the finger(s) or thumb. With trigger finger or trigger thumb, the tendons become irritated and swollen (inflamed) and can no longer easily slide through their sheaths. A bump (nodule) may also form on the tendon, which makes it even more difficult for the tendon to easily glide through its sheath.

Are there home remedies for trigger finger?

Initially, people can treat trigger finger at home with remedies including cold packs, resting, and over-the-counter medications, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen. Massaging the involved area of the palm gently followed by cold pack application can be helpful. Take care to avoid reinjuring the strained tendon in the palm.

If your finger does not get better with nonsurgical treatment, you may wish to consider surgery. Surgery is elective. The decision for surgery is based on how much pain or loss of function you have in your finger. If, however, your finger or thumb is stuck in a flexed or bent position, your doctor may recommend surgery to prevent permanent stiffness

How can physiotherapy help?

Modalities such as heat/ice, ultrasound, electric stimulation, massage, stretching, and joint motion (active and passive) can have some positive effects on trigger finger. It is thought that heat can help by providing increased blood flow and extensibility to the tendon. Following heat with stretching can provide more extensibility with plastic deformation. Joint movement and mobilisations increase joint and soft tissue mobility via a slow, passive therapeutic traction and translational gliding.

Recently, extracorporeal shock wave therapy (ESWT) has been advanced as a possible alternative to surgery for the treatment of musculoskeletal disorders in patients recalcitrant to traditional conservative treatment.