Trigger finger, also known as stenosing tenosynovitis, is a common hand condition that can cause pain, stiffness, and locking in your fingers or thumb. It occurs when the flexor tendon, which is responsible for bending your fingers, becomes inflamed and irritated. This inflammation narrows the space within the tendon sheath (structure that surrounds the tendon and lubricates its movement) and a nodule is formed. The narrowed space makes it difficult for the tendon to glide smoothly through the pulleys, a tunnel-like tissue that straps the tendon down to the bone, causing the finger to catch, click or lock in a bent position.

What are the symptoms of trigger finger?

The symptoms of trigger finger can vary depending on the severity of the condition. Here are some of the most common symptoms:

  • Catching or popping sensation: You may feel a snapping, clicking, or popping sensation in your finger when you bend or straighten it.
  • Stiffness: Your finger may feel stiff, especially in the morning.
  • Pain: You may experience pain along the finger on the palmar side of the hand, but most commonly at the base of your finger.
  • Locking: In severe cases, your finger may become locked in a bent position and be difficult to straighten.

What causes trigger finger?

Trigger finger can be caused by a number of factors, including:

  • Repetitive gripping and direct pressure: Activities that involve repetitive gripping, such as typing, playing certain sports, or using tools, can irritate the flexor tendon and its sheath.
  • Medical conditions & medications: Certain medical conditions, such as rheumatoid arthritis, diabetes, and hypothyroidism, can increase your risk of developing trigger finger. Hand swelling can also be a common side effect of some medications especially in heart conditions and cancer treatment and may lead to trigger finger.
  • Pregnancy: Pregnancy can cause fluid retention in the body, which can contribute to trigger finger.

How is trigger finger diagnosed?

Trigger finger can usually be diagnosed by a physical examination. Your hand therapist will ask you about your symptoms and perform passive and active range of motion tests. In these tests, the therapist will assess where the trigger is happening on the finger, which can vary from person to person. If you experience pain or a popping/clicking sensation during the active range motion tests, it is a strong indication of trigger finger.

How is trigger finger treated?

The treatment for trigger finger depends on the severity of the condition. Here are some of the most common treatment options:

  • Rest: Avoiding activities that aggravate your symptoms can help to reduce inflammation and allow the tendon to heal.
  • Splinting: Wearing a custom splint at night or during activities can help to immobilize the affected finger and prevent further irritation.
  • Ice: Applying ice to the affected area for 5 minutes at a time, several times a day, can help to reduce pain and inflammation in acute cases.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs): Over-the-counter pain relievers, such as ibuprofen or naproxen, can help to reduce pain and inflammation. See your doctor for appropriate medical advice.
  • Corticosteroid injection: A corticosteroid injection can be injected into the tendon sheath to reduce inflammation and improve flexibility if conservative approach fails.
  • Surgery: In severe cases, surgery may be necessary to release the pulley and allow the tendon to glide smoothly.

Custom Splinting vs. Off-the-Shelf Options

Splinting is a common treatment for trigger finger, and there are two main types to consider: custom-made splints and off-the-shelf splints. While off-the-shelf splints can offer a readily available and affordable solution, custom-made splints provide several advantages:

  • Improved Fit and Comfort: A custom splint is molded to the specific contours of your finger, ensuring a more comfortable and secure fit that can be adjusted as your finger changes. This can be especially important for prolonged wear, for fingers with unusual shapes or significant swelling.
  • Targeted Immobilization: A custom splint can be designed to target the specific area of inflammation or restrict movement in a way that an off-the-shelf splint might not. This can help to promote faster healing and reduce the risk of further irritation. By restricting only the affected area, custom splinting can stave off the unaffected areas from immobilization, diminishing finger stiffness and allowing some functional movements.
  • Enhanced Support: Custom splints can be crafted from more rigid materials or incorporate additional features to provide a higher level of support for your finger. This can be beneficial for severe cases of trigger finger or for individuals who require additional stability.

Conservative management is key

Conservative management, which includes rest, splinting, ice, NSAIDs, and physiotherapy, is usually effective in treating trigger finger. Early diagnosis and treatment can help to prevent the condition from worsening and avoid the need for surgery.

If you are experiencing any of the symptoms of trigger finger, it is important to see a physiotherapist for diagnosis and treatment. Early intervention can help to improve your symptoms and prevent the condition from worsening.