What is Trigger Finger?
Trigger finger, or flexor tenosynovitis, is a diagnosis we see fairly often at LB Hand Therapy. The tendons that bend your fingers toward your palm are your flexor tendons. They travel through the carpal tunnel at the wrist (see last week’s post). The tendons then travel through your palm and go to each finger in order to bend that finger. Along the tendon there are structures called “pulleys” which hold the tendons in place. When the tendons become inflamed or swollen, they will start to get stuck while gliding under the pulleys. Occasionally, this inflammation can become bad enough that the finger will lock as the thicker part of the tendon slides under the pulley but then is unable to pull back under the pulley as you straighten your finger.
Most often our patients complain of a sore spot in their palm or a swollen finger. It can also be so bad the finger is locking in a bent position. Typically we see swelling in the middle joint of the finger (the PIP joint). You may experience an arthritic-type pain in the morning as your finger is likely swelling more at night. Our patients often complain that their finger is more sore upon waking or after resting the hand.
How Do You Get Trigger Finger?
The tendons can become inflamed for any number of reasons. A lot of times it is caused by the repetitive activity of gripping or squeezing. Occasionally, people who work with vibrating tools with also get trigger fingers. Unstable blood sugar levels, as seen in patients with diabetes, can also bring on trigger fingers. Anything, be it vibration, repetitive use, or even salty foods, that causes swelling in your body can exacerbate trigger fingers. Swollen tendons do not fit under their pulleys.
Treatment for Trigger Finger
Treatment of trigger fingers consists of rest, ice, and swelling reduction. Your therapist may recommend a splint to keep your finger from clicking. The more the tendon rubs under the pulley, the more irritated it becomes. When traditional therapy treatments are unsuccessful, your doctor may suggest a cortisone injection or surgery. The surgery is a minor procedure in which they release the pulley to allow the tendon to glide freely. Often, your doctor will refer you to therapy after surgery to help with swelling and scar tissue. If you have had trigger finger surgery, but your doctor did not refer you to hand therapy, ask your primary care physician for a referral. Therapy can expedite your recovery and help manage your pain and scarring.
LB Hand Therapy Can Help!
Have you noticed clicking or locking in any of your fingers? Are there sore and tender areas in your palm? Trigger finger can resolve with conservative treatment, so contact us today to see if therapy can help! Visit our Where to Begin page to become a patient.