Trigger finger is caused when a tendon cannot glide smoothly through its pulley, causing a catching or locking effect when a person makes a fist and then attempts to straighten the fingers out again. Trigger fingers occur when either the pulley becomes thick and inflamed, making it hard for the tendon to travel through smoothly, or when the underlying tendon becomes irritated and swollen, preventing it from gliding under the pulley.
Trigger finger or trigger thumb is a common hand condition caused by overuse, repetitive gripping or pinching or, less commonly, from direct trauma. It causes catching or locking of the digit during functional gripping and in severe cases can become stuck in a bent position.
Trigger finger can be caused by overuse, repetitive movement or direct trauma to the area. Other contributing factors include diabetes, arthritis and fluid retention resulting in increased swelling in the hand.
Symptoms of trigger finger or thumb include a clicking or popping sound when making a fist. This is often felt in the middle joint of the finger or end joint of the thumb rather than at the actual site of the catching which occurs in the palm. There can be a catching or locking sensation when flexing into a fist or straightening the finger.
In severe cases, sufferers may not be able to actively straighten the finger and will need to use their other hand to help straighten the locked finger. Other symptoms include pain or tenderness at the base of the affected finger and a small lump or nodule where the finger catches.
Non-surgical options include a custom-made splint to limit bending of the affected finger or thumb. The splint allows the tendon to rest and reduces swelling while still allowing the top of the finger to move for everyday tasks.
Ultrasound treatment, massage and use of anti-inflammatory gels help reduce inflammation of the tendon and pulley. A hand therapist can help patients to avoid repetitive activity and suggest certain modifications at home and at work.
If there is no relief from the above treatment, patients can receive a cortisone injection. If this is unsuccessful, a surgical procedure called a “trigger finger release” might be required. Surgery is performed through a small incision in the palm and the affected pulley is opened to allow a wider space for the tendon to glide.
Our therapists at Melbourne Hand Therapy will expertly assess your condition to help determine which pulley is causing the problem. Most trigger fingers can be managed well with conservative management provided by our experienced therapists. Your treatment will include the fabrication of a custom made splint, ultrasound treatment and massage. We will advise on activity modification, appropriate exercises and function whilst wearing the splint.
As the pain and triggering settle your therapist will guide you by recommending appropriate exercises, strengthening and returning to all normal activities also helping to prevent reoccurrence. If splinting is ineffective we can assist in organising a cortisone injection or referral to one of our hand surgeons for a surgical opinion.
If you are experiencing any of these symptoms, book an appointment.