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What Is Trigger Finger?

Trigger finger is an inflammation of tissue inside your finger or thumb. It is also called tenosynovitis (ten-oh-sin-oh-VY-tis). Tendons (cordlike fibers that attach muscle to bone and allow you to bend the joints) become swollen. So does the synovium (a slick membrane that allows the tendons to move easily). This makes it difficult to straighten the finger or thumb.

Causes

Repeated use of a tool, such as a drill or wrench, can irritate and inflame the tendons and the synovium. So can arthritis or an injury to the palm of the hand. But often the cause of trigger finger is unknown.

Symptoms

The first sign of trigger finger may be pain where the finger or thumb joins the palm. You may also notice some swelling. M the tendon becomes more inflamed, the finger may start to catch when you try to straighten it. When the locked tendon releases, the finger jumps, as if you were releasing the trigger of a gun. This further irritates the tendon, and may set up a cycle of catching and swelling.

Your doctor can usually tell from examining your finger or thumb whether a tendon is inflamed. Your treatment will depend on how severe your condition is.

Evaluating Your Finger

Your doctor will ask you to make a fist and then straighten your fingers. The affected finger or thumb may stay curled and then suddenly pop to a straight position. Or you may have to straighten it with your other hand. Your doctor may also feel for tenderness and swelling at the base of the finger or thumb.

Nonsurgical Treatment

If your symptoms are mild, your doctor may have you rest the finger or thumb and take oral anti-inflammatory medication, such as aspirin. If this does not reduce the swelling, your doctor may give you injections of an anti-inflammatory, such as cortisone, in the base of the finger or thumb.

Surgery

If other treatments don't relieve your symptoms, your doctor may recommend surgery. The sheath that surrounds the tendon is opened to enlarge the space and release the swollen tendon. This allows the finger to bend and straighten normally again. Surgery takes about 20 minutes, and can often be done under a local anesthetic. You can usually go home the same day. Your hand will be wrapped in a soft bandage, and you may wear a plaster splint for a short time to keep the finger stable and more comfortable. The stitches will be removed in about 2 weeks. Your doctor will discuss the risks and possible complications of surgery with you.

Inside Your Finger

Tendons connect muscles in your forearm to the bones in your fingers. The tendons in each finger are surrounded by a protective tendon sheath. This sheath is lined with synovium, which produces a fluid that allows the tendons to slide easily when you bend and straighten the finger. If a tendon is irritated, it becomes inflamed.

When a Tendon Is Inflamed

When a tendon is inflamed, it causes the lining of the tendon sheath to swell and thicken. Or the tendon itself may thicken. Then the sheath pinches the tendon, and the tendon can no longer slide easily inside the sheath. When you straighten your finger, the tendon sticks or "locks" as it tries to squeeze back through the sheath.

Using Your Finger Again

The goal of your treatment is to relieve your pain and allow you to straighten your finger or thumb again without its sticking. Once the tendon is no longer inflamed, your doctor may give you exercises to help you regain movement in the finger. You may also need to vary the way you hold or lift things. Following these directions will help you get back to your normal activities.