Trigger Finger

Trigger finger is a common and painful disorder of a finger’s flexor tendon that causes the finger to “catch” or “lock” when bent or released (if the thumb is affected, the condition is called “trigger thumb”). Trigger finger can be caused by repetitive motion of the finger, rheumatoid arthritis, diabetes and gout. Grasping something for an extended period of time can also result in trigger finger.

The fingers and thumb are able to bend and straighten because of tendons and muscles in the hands and arms. A tendon usually moves smoothly through the sheath (tissue) that covers it. However, when a finger’s flexor tendon becomes inflamed, it may not be able to move smoothly through the sheath so that, when an attempt is made to bend or release the finger, the pulling of the enlarged tendon through the sheath results in the tendon’s catching or locking. The medical term for trigger finger is “stenosing flexor tenosynovitis.”

Symptoms Of Trigger Finger

Trigger finger is usually more common in the dominant hand, and in the middle and ring fingers, or the thumb. Symptoms often get progressively worse, and may include:

  • Popping or clicking sensation when finger is moved
  • Finger stiffness, especially when first waking up
  • Nodule or tenderness at the finger’s base

It is also possible that the finger, after catching or locking when bent, will suddenly pop straight. The reverse is also possible: The finger may lock in the bent position and be unable to be straightened.

Treatment Of Trigger Finger

Applying ice, stretching and taking nonsteroidal anti-inflammatory medications are recommended treatments for trigger finger. However, the quickest and most effective treatment is a cortisone injection into the affected tendon’s sheath. If the trigger finger does not go away after two injections, and is not helped by ice, stretching or anti-inflammatories, surgery may be recommended. During surgery for trigger finger, the tendon sheath is released, and/or inflamed or scarred tissue is removed. Surgery usually permanently cures trigger finger.

Trigger Finger Release

De Quervain’s Tenosynovitis

De Quervain’s tenosynovitis is an inflammation of the two tendons that run from the back of thumb and down the side of the wrist. The causes of De Quervain’s tenosynovitis are unknown, but it has been linked to wrist injury, overuse/repetitive motion, pregnancy and inflammatory arthritis. It is much more common in women than in men, and in people who have diabetes or arthritis. The disease was first identified in 1895 by Fritz de Quervain, after whom it is named.

Symptoms Of De Quervain’s Tenosynovitis

De Quervain’s causes pain, swelling and tenderness over the thumb side of the wrist, and makes gripping difficult. The index finger and the back of the thumb can feel numb, and moving the wrist or thumb can cause a squeaking or creaking sound. It is also possible for a small bump to form on the thumb side of the wrist. If left untreated, de Quervain’s can get worse, with pain spreading up the forearm or down to the thumb.

Treatment Of De Quervain’s Tenosynovitis

De Quervain’s tenosynovitis can be diagnosed through the Finkelstein test, in which the patient makes a fist with the thumb tucked inside, and then bends the wrist toward the pinky finger. If the patient feels pain on the thumb side of the wrist, de Quervain’s is likely the cause. Treatment for de Quervain’s tenosynovitis focuses on relieving pain and minimizing swelling through the use of anti-inflammatory medication, corticosteroids, splints and rest. Surgery to make more room for the irritated tendons may be recommended in severe cases.