When Your Finger’s Too Triggered for Its Own Good!

Dr. Kaiwan Randeria is a board certified orthopaedic surgeon practicing in Mumbai, holding a fellowship in Complex Joint Replacements. For Queries: drkaiwan94@gmail.com 

For several people worldwide, everyday tasks like gripping a pencil, typing on a keyboard, or simply holding a cup can become a painful challenge. One condition that interferes with such basic movements is ‘trigger finger’ – a form of tendinitis (inflammation of tendons) affecting the tendons that control finger movement, causing the affected finger to get ‘stuck’ in a bent position before suddenly popping straight. This condition can lead to discomfort, frustration, and even permanent damage to the finger if left untreated.

What is Trigger Finger?
Trigger finger (medically known as stenosing tenosynovitis) is a condition where one of the tendons in the fingers or thumb becomes irritated and inflamed. Tendons facilitate muscles to move bones, and in the case of the fingers, they allow flexion and extension (bending and straightening). When a tendon becomes inflamed, it can cause a narrowing of the tunnel through which the tendon passes, known as the tendon sheath, most commonly at a site named as the ‘pulley’. This narrowing creates a ‘catching’ sensation, where the tendon gets stuck as it moves, resulting in the finger becoming locked in a bent position. In some cases, the finger may snap or pop straight suddenly, resembling the action of pulling and releasing the trigger of a gun, hence the term ‘trigger finger’. While the condition is often temporary, some people experience chronic symptoms that can interfere with daily activities and impact the quality of life.

Causes of Trigger Finger
Trigger finger typically develops when there is inflammation or swelling in the tendon sheath. Several factors can contribute to the development of this condition:

Repetitive Motion: Recurring gripping or grasping motions, like those often performed in certain occupations (e.g., carpenters, musicians, factory workers) or sports, can lead to the overuse of the tendons in the fingers, causing irritation and inflammation of the tendons.

Underlying Medical Conditions: People with conditions such as diabetes, rheumatoid arthritis, or gout are at an increased risk of developing trigger finger due to the way these conditions affect the body’s inflammatory responses.

Age and Gender: Trigger finger is more common in adults, particularly between the ages of 40 and 60. Women are more likely to develop this condition.

Previous Injuries: to the hand, fingers, or wrists can make the tendons more susceptible to becoming irritated and inflamed, leading to the development of trigger finger.

Symptoms of Trigger Finger
These vary depending on the severity of the condition, but generally progress through a series of stages. Some of the most common symptoms include:

Pain and Tenderness: in the affected finger is often the first symptom. It could be localized at the base of the finger or near the palm, and worsen with gripping or grasping motions.

Stiffness: People with trigger finger often experience stiffness in the affected finger.

Snapping or Popping Sensation: One of the hallmark symptoms of trigger finger is the sensation that the finger gets ‘stuck’ and suddenly releases with a popping or snapping sound, resembling the motion of a trigger being pulled.

Locking or Sticking of the Finger: In severe cases, the finger may become permanently stuck in a bent position and may require manual assistance to straighten out.

Swelling: In some cases, there may be visible swelling at the base of the affected finger or thumb.

Diagnosis typically involves a physical examination by an orthopaedician, who could ask the patient to move the fingers and observe for signs of snapping or locking. The doctor may also apply pressure to different parts of the tendon to check for tenderness or swelling. In some cases, imaging tests such as X-rays or ultrasounds may be ordered to rule out other potential causes of the symptoms. One should not attempt to self-diagnose these conditions.

Treatment Options for Trigger Finger
In many cases, the condition can be managed with conservative measures, but more severe or persistent cases may require medical intervention. The following treatment options are commonly used:

Rest and Activity Modification: Resting the affected finger and avoiding activities that aggravate the condition, such as gripping or repetitive motions, is the first step in treatment. Using a splint to immobilize the finger may also help relieve pressure on the tendon.

Anti-inflammatory Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs), help reduce pain and inflammation. They should be prescribed by a qualified health professional after ruling out any allergies/ underlying health issues.

Stretching and Exercise: Gentle stretching exercises can improve flexibility and reduce stiffness. A physiotherapist may provide specific exercises to help strengthen the muscles and tendons of the hand.

Steroid Injections: If pain and inflammation persists despite conservative measures, corticosteroid injections may be used to reduce swelling and provide relief. While this treatment provides relief within a few days, repeated injections may lead to side effects such as tendon weakening, so they are not a long-term solution.

Surgical Intervention: If the condition is severe and the finger is locked in a bent position, surgery may be considered. The surgical procedure involves releasing the constricted tendon sheath to allow the tendon to move freely.

Prevention of Trigger Finger
Certain steps could reduce the risk of developing the condition:

Avoid repetitive stress: Taking breaks from repetitive tasks and using proper ergonomics when working with tools or performing manual labour can reduce strain on the tendons.

Stretch and warm-up: Before engaging in activities that require gripping, it’s helpful to stretch and warm up the fingers to increase flexibility and reduce the risk of injury.

Manage underlying health conditions: Managing chronic health conditions like diabetes or arthritis through medication, diet, and lifestyle changes can help minimize the risk of developing trigger finger.

Trigger finger may seem like a minor annoyance at first, but it can become a troublesome condition if left untreated. With early intervention, people may find relief and resume normal activities without significant long-term consequences.

[Disclaimer: The contents of this article should not be considered as formal medical advice and one should not attempt to self-diagnose. Kindly visit your Orthopaedician for any related treatment.]