The disorder is also named “stenosing tenosynovitis.” The thumb and ring finger are mostly affected by the trigger finger, but they can also affect the other fingers. The condition is known as “trigger finger thumb when the thumb is affected.”
Causes
Trigger fingers are common with some medical conditions. Diabetes, Rheumatoid arthritis, and Gout are the common risk factors for this condition. Strong and repeated gripping leads to the condition. In most cases, the cause of the trigger finger is not known.
Signs and symptoms
Some symptoms of trigger finger can include:
Pain:
Trigger finger starts with discomfort experienced at the base of the affected thumb or finger, where the finger joins the palm. These are only the initial symptom. This pain causes by pressure on the A1 pulley area. The pain is usually only felt with activity like gripping. When at rest, it doesn’t hurt. Over time, if there is augmented fluid production in the muscle sheath, this causes pressure and pain even without hand use.
Swelling:
With time, there is the development of a cyst in the A1 pulley. This is because of a nodular swelling in the muscle or a fluid-filled cyst development. The cyst is known as a flexor sheath ganglion.
Stiffness or loss of motion:
A trigger finger disease results in losing the capability to fold the finger. This is diagnosed by how far the tip of the finger goes from the palm. This is most common in untreated, chronic trigger fingers. It is painful to try and fold the finger because of the compression of the liquid. Over time, the person starts to prevent a folded position of the finger to restrict pain. Trigger fingers thumb also result in loss of the ability to stretch the finger. Some patients feel the pain trying to straighten their fingers fully. When the joint does not completely straighten out for some weeks, a tendon called the volar plate gets shortened and restricts motion.
Mechanical symptoms:
A trigger finger causes abnormal movement or sensations usually described as locking, popping, or catching. Sometimes these abnormal feelings happen while stretching or straightening the finger. Previously, the symptoms were slightly painful previously, but the pain increases as the muscle and pulley interaction get tighter.
Nonsurgical treatment:
Natural treatment for trigger finger aims to reduce or remove the swelling and catch or lock, allowing complete, painless movement of the thumb or finger. The ability to bring back the finger’s motion that the patient believes is normal or 100% is simpler when the problem is identified and treated once possible.
Common treatment choices include, but are not limited to:
Splinting at night:
It is estimated that much of the body’s fluid volume pools in the legs during the day when we sit and stand due to the effects of gravity. When someone lays flat at night, the effect of gravity on the legs is more similar to the arms so that fluid may shift from the legs to the arms. This may increase swelling in the fingers, where pain and locking are more frequent and happens at night and in the early morning. Using taping for trigger thumb to keep the finger straight prevents painful locking while sleeping. However, keeping the finger straightened all night results in the need to do some effort and give time to get it to move smoothly in the morning.
Nonsteroidal anti-inflammatory drugs (NSAIDs):
Many times, oral anti-inflammatory medication is recommended to relieve pain and enhance the ability to move the finger through a large curve.
Changing your activity:
It is possible to restrict or space out the amount of time used in forceful, repetitive, or continuous gripping.
Steroid injection:
Corticosteroid injections also called cortisone shots are given at any stage of symptoms or duration. However, there is a better success when they are given early.
Hand therapy:
Patients are benefited from some supervised and home exercises. In addition, it is helpful to have a hand therapist teach concepts and techniques like passive joint motion, muscle differential muscle gliding, proximal joint blocking to isolate more distal joints, edema control, and other actions.
Surgical Treatment:
If your finger still stays the same and does not get better with nonsurgical treatment, consider surgery. Surgery is optional. The decision for surgery depends on how much pain or loss of job you have in your finger. If your thumb or finger is stuck in a bent or flexed position, your doctor will recommend surgery to avoid permanent stiffness.
Surgical procedure:
The surgical process for the trigger finger is called “tenolysis” or “trigger finger release.” This technique aims to release the A1 pulley that hinders muscle movement, so the flexor muscle glides more easily through the muscle sheath. Usually, the process is done in a case setting with an anesthesia injection to numb the area for surgery.
This trigger finger pain relief treatment is performed either by a small incision in the palm or with the tip of a needle. The A1 pulley is separated so that the flexor muscles glide freely. Although pulleys have a vital function in hand, releasing the A1 pulley must not cause problems in the future.
Outcome:
Patients undergoing surgery feel significant improvement in working as well as relief from the pain of a trigger finger. Still, if a contracture or loss of motion is present before surgery, the full range of motion is restored.