Tendons are the tissue that attaches muscles to the bone. In the trigger finger, the smooth movement of the tendon is inhibited. It leads to sudden catching, clicking, and locking of the involved finger when trying to straighten it. People often complain of a snapping or popping sensation. Trigger finger is more common in people with diabetes and rheumatoid arthritis. It is more prevalent in females than males and the age group of 40-60years.
Trigger fingers can affect one or more fingers, the ring finger and the thumb are commonly affected. It can affect both hands too. When it involves the thumb, it is known as the trigger thumb. Trigger finger is also known as stenosing tenosynovitis.
Trigger finger results from trauma or overuse. It is common in those occupations that require frequent grasping and gripping activities, or require repetitive, forceful movements of fingers like musicians. In some cases, it is idiopathic. In the trigger finger, either the tendon or the tendon sheath gets inflamed. The inflamed tendon becomes swollen, hampering the smooth movement of the tendon.
In mild cases, the affected finger only has pain and tenderness. When it progresses, it leads to the catching of the finger. Later it leads to the finger locking in a flexed position that can be straightened passively. But in severe cases, the finger becomes locked with flexion at the proximal interphalangeal (PIP) joint.
Symptoms of trigger finger are worse after a period of inactivity, for example, in the morning after you wake up and when trying to grasp something firmly. Sometimes a nodule is also formed on the tendon that impacts the hand activities.
Treatment of Trigger Finger-
- Resting from aggravating activities is the first step to alleviating the symptoms. Sometimes splinting is done to keep the finger in the extended position.
- Anti-inflammatory medications (NSAIDs) and steroid injections help to reduce inflammation.
- Stretching exercises help with smooth movement. Finger massage along the tendon helps to loosen any thickening and scarring that obstructs the smooth glide of the tendon within the tendon sheath. Firm and gentle pressure are needed. Tendon gliding exercises and passive joint ROM also help.
- Therapeutic ultrasound also aids in healing by reducing inflammation and promoting repair.
- Surgical release is for severe cases where the finger is fixed in the locked position.
Exercises for Trigger Finger-
Finger lifts-Place your hand flat on the table, then gently lift each finger. Pull it upwards with passive stretch from the other hand. Hold the lift for 2-3 seconds. Repeat this exercise about ten times for each finger.
Fingers spreading-Place your hand on the table with your palm facing down and fingers together. Now spread your fingers apart, hold for 2 seconds and bring them together. Repeat ten times.
Rubber band stretching– Wrap a rubber band around two adjacent fingers just below the fingernail and try to pull the fingers apart. This exercise will work up the interossei muscles of the hand. Repeat ten times on each finger pair.
Making an “O” with the fingers and thumb– Hold for 5 -10 seconds and release. Repeat five times.
Thumb to finger pinches-With your thumb, touch the tips of each finger one by one, starting from the index finger to the little finger. Hold each pinch grip for 2-3 seconds.