Trigger finger is also know as stenosing tenosynovitis (swollen tendon) or stenosing tenovaginosis (swollen tendon pulley). Trigger finger occurs when there is a problem with either the tendon, the sheath or the pulley caused by injury, inflammation or disease.
The tendons involved (FDS and FDP) are like strong sinews. They join the flexor muscles in the forearm to the finger bones and when stimulated they bend each finger towards the palm.
Each tendon is coated in a lubrication sheath which helps it to glide easily through a pulley at the base of each finger.
Tenosynovitis describes the tendon bunching up to produce a knot or bump which gets caught in the pulley when trying to bend or straighten the finger. The tendon can painfully release suddenly or click open and is worse when gripping or in the morning.
Less common is swelling inside the pulley, called tenovaginatis, which describes the space for the tendon shrinking. Pressure placed on the tendon as it tries to move through the pulley causes friction and additional swelling on the sheath over time.
In cases that have developed suddenly, the tendon can become completely wedged inside the pulley making it very painful or impossible to straighten out the finger. It is best to seek immediate treatment to reduce acute inflammation before attempting to prise the finger open. Try an ice compress with complete rest and then gently straighten the finger while bathed in warm water. Go slowly to reduce the risk of tearing the tendon sheath causing lubricating fluid to leak into the palm.
Chronic cases occur when the person describes little or no pain but has triggering of the finger with every movement. At best it is annoying. At worst it signals that the pulley has stretched abnormally and the tendon has toughened which can lead to problems down the road.
Occupations involving tightly gripping tools and levers that repeatedly press against the pulleys in the palm of the hand create a greater risk of developing irritation to the pulley and tendon mechanism and therefore chronic Trigger finger. see
RSIAt Hand Kinetics treatment starts straight away. A small trigger finger splint rests the tendon and pulley mechanism and provides immediate relief from pain and disability. After 3/4 weeks of rest the affected tendon returns to normal size and light activities can be re-introduced.
Other non-surgical treatments used in combination with a resting finger splint include the following:
- Wax therapy to soften stiff connective tissues before exercise
- Ultrasound to help healing tissues align in the correct position
- Stretching muscle exercises to maintain length and strength in the tendons
- Massage to stimulate capillary action and reduce swelling
- Activity modification to prevent recurrence
If you feel your problem is chronic, don't worry. Hand Kinetics can assess the problem and can recommend your GP organise injection therapy in combination with non-surgical treatment methods.
Hand Kinetics Telephone: 0044 28 417 72301
www.handkinetics.com
contactus@handkinetics.com
