What is trigger finger?
Trigger Finger is a condition that affects flexion in either a finger or thumb and is medically referred to as Stenosing Tenosynovitis. It specifically causes inflammation of the tendon sheath and thickening of the tendon that controls one of your fingers. This results in a stiffening of the affected finger, leading to a catching or clicking sensation that interrupts the smooth motion of bending and straightening the finger. In severe cases this can eventually lead to the affected finger or thumb locking into a bent position. It is also possible that more than one finger is affected, or that you develop the condition in the fingers both hands. As the inflammation progresses and movement of the finger becomes restricted, the pain and tenderness can increase inhibiting functionality of the entire hand.
What causes Trigger Finger?
Each finger and thumb has a fibrous cord called a tendon that allows you to pull the finger toward the palm during flexion. Trigger finger develops as a result of irritation to the sheath that wraps around, protects and reduces friction to the tendon during movement. The irritation can cause inflammation of the sheath, which in turn compresses the tendon inside causing abrasion. Over time, the continued friction on the tendon causes scar tissue to develop that thickens the tendon. Resulting in further irritation to the sheath and progressively restricted tendon movement. If a sufficiently large nodule of scar tissue develops on the tendon, which cannot pass through the tendon sheath, than the finger can lock into a flexed position.
Often the exact cause of tendon and sheath inflammation that leads the development of Trigger Finger is unclear. However, there is evidence showing repetitive strain injuries or inflammatory illnesses greatly increase your risk of developing Trigger Finger. This would include conditions like rheumatoid arthritis, diabetes and gout or performing repetitive tasks during work, that require you to grip intensely for prolonged periods. The risk would also increase if you had previously suffered trauma to the finger from injury or associated conditions like De Quervain's Tenosynovitis or Dupuytren's Contracture. The incidence of Trigger Finger development is also much higher amongst women and people over the age of 40 years.
What are the symptoms of Trigger Finger?
The symptoms of Trigger Finger will vary depending on the severity of the condition, but may include the following:
- Tenderness in the soft tissues at the base of the finger.
- Stiffness, most noticeably after periods of inactivity, such as when awakening in the morning.
- A nodule of scar tissue may be detectable at the base of the finger, when pressed.
- Clicking sensation as the finger bends and extends.
- Stronger catching and sudden releasing during finger movement as condition progresses.
- Finger locks in flexed position, unable to straighten without assistance from other hand.
- Surgery, where the restricting tendon sheath if cut to allow free movement.
- Rest, to avoid activity that will agitate the inflammation in the tendon and sheath.
- Ice therapy to relieve pain and reduce swelling.
- Heat treatments, including wax therapy, to increase tissues extensibility prior to stretches.
- Ultrasound therapy to promote normal soft tissue healing.
- Advice on use of customised splints during the night to maintain finger flexibility
- Stretches, both passive and active, to maintain range of motion in the palm and fingers.
- Dexterity exercises to maintain functional strength and co-ordination.
- Advice on activity modification during recovery and to prevent reoccurrence.
- Soft tissue massage to relieve stiffness once inflammation is gone.
- Oral anti-inflammatory medication.
- Steroid injection into the area around the tendon sheath to reduce inflammation.
- Percutaneous Release, using anaesthetic and a needle to debride any fibrous constriction of the tendon and sheath.
- Surgery, where the restricting tendon sheath if cut to allow free movement.
How is Trigger Finger diagnosed?
For further information about how Physiotherapy can help treat trigger finger, or to book yourself an appointment, please email office@liverpoolphysio.co.uk or ring us on 0151 558 0077.
How can I arrange a physiotherapy assessment for Trigger Finger?
If you are experiencing pain and stiffness in one of your fingers and feel a catching sensation when moving that finger, you may have Stenosing Tenosynovitis commonly referred to as Trigger Finger. If you suspect you have developed Trigger Finger, you would benefit from an assessment with one our experienced physiotherapists.
Subjective
A discussion to find out how long your condition has been persisting, if you have had any previous injuries in this area, what symptoms you are experiencing and how your condition is affecting you and your lifestyle.
Objective
A physical assessment of your range of pain, tenderness in the area, range of movement and a series of special tests to identify exactly which structures are likely to be affected.
What does physiotherapy treatment for Trigger Finger involve?
Where possible in the earlier stages of Trigger Finger development, the condition will be treated conservatively. Such treatment may include:
For more severe or developed cases of Trigger Finger a surgical or medical intervention may be considered. This may be necessary to alleviate pain and gain sufficient mobility for other treatments to be effective. Such interventions may include;
Our experienced physiotherapists at Liverpool Physio will tailor a personalised treatment plan based on the presentation of your symptoms. Whatever the severity of your condition, every session will work toward reducing pain, regaining mobility and returning to the functional tasks of daily living. The earlier you begin treatment after diagnosis the faster and fuller your recovery will be.
For more information about physiotherapy for a trigger finger, or to book an appointment please email office@liverpoolphysio.co.uk or call 0151 558 0077.
How can I arrange a physiotherapy assessment for Trigger Finger?
If you are experiencing pain and stiffness in one of your fingers and feel a catching sensation when moving that finger, you may have Stenosing Tenosynovitis commonly referred to as Trigger Finger. If you suspect you have developed Trigger Finger, you would benefit from an assessment with one our experienced physiotherapists.
You can contact us directly to arrange an assessment and we can advise you if further treatment is recommended, or give you details on self-management for minor cases. To arrange an appointment please email office@liverpoolphysio.co.uk or call 0151 558 0077.
Summary
Stenosing Tenosynovitis, or Trigger Finger, can be initially uncomfortable and as it develops it can limit functionality of the hand entirely. Early detection and treatment can allow for conservative management, leading to a quick and full recovery. Whatever stage of development your Trigger Finger has reached, physiotherapy can help relieve pain and stiffness. Heat treatments, stretches and the use of splints will all help you recover and return to the normal daily activities you enjoy.
For further information about how Physiotherapy can help treat trigger finger, or to book yourself an appointment, please email office@liverpoolphysio.co.uk or ring us on0151 558 0077.
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