Trigger Finger

Hello and welcome back to the ThreeSpires Physiotherapy blog where we take a look at all things physiotherapy and health related. As we were looking at the hand in our last physiotherapy article I thought we could continue on this theme and area of the body and look at another problematic condition of the hand called Trigger Finger. This is a fairly common and difficult condition to treat with symptoms that can just simply be annoying to loss of function of the finger involved and is something that as physiotherapists we help patients with. Just to remind anyone who is not a regular reader of this physiotherapy blog: we are a home visit physiotherapy service based in Lichfield and offering services in Sutton Coldfield, Tamworth, Cannock, Rugeley and Walsall.

What is Trigger Finger?

Trigger Finger which is also known as stenosing tenosynovitis is a reasonably common condition that affects the fingers (usually the ring, little finger or thumb are affected) and causes a sensation of clicking and locking of the finger or thumb as it is either straightened or bent. It can be quite painful and is usually worst in the morning. For anyone reading this blog without a good understanding of hand anatomy: tendons are the cables that connect your muscles in the forearms to the bones in your fingers. When you grip with your hands and fingers the muscles in your forearms contract and pull on the tendons. To reduce friction and stop them wearing out these tendons run through lubricated sheaths and it is this movement through the sheath that is affected in trigger finger.

What Causes Trigger Finger?

The clicking or locking is caused by the tendon itself becoming swollen and inflamed and then becoming restricted as it runs through the tunnel of the tendon sheath. Research shows that it is more common in the right hand but this may well be because most people are right handed and this is the hand that is most commonly doing pinching and gripping tasks and therefore is the hand most prone to getting inflamed tendons. As mentioned trigger finger happens when a tendon becomes inflamed, this will then cause the tendon to swell and it can then bunch up and get caught in the tendon sheath (usually at a point where the sheath runs underneath a ligament) this will then give the typical catching sensation that patients feel in their finger.

What are the Symptoms of Trigger Finger?

Generally it will be felt in the index finger or thumb most commonly and patients will describe a clicking, catching or locking sensation in the finger. They may also be able to feel a lump in the finger that moves as they make a fist. Often things are worse in the morning when the hand has not been moving all night.

Who is Likely to get Trigger Finger?

Pretty much anyone can get trigger finger and the exact cause of trigger finger is a matter for debate and research. Certainly though, it is more common as people age and it is also more common in women and those with conditions such as diabetes and rheumatoid arthritis.

What is the Treatment for Trigger Finger?

Trigger finger has a variety of treatment options and below I have described a reasonable process that patients with trigger finger should generally go through:

1. Have an Assessment: yes, I know this sounds obvious but before deciding to get your trigger finger treated it is important to be certain that you actually have trigger finger and not some other condition. Articles like this one about trigger finger are helpful but are not meant to replace a thorough assessment by a physiotherapist or a doctor and a confirmation that you do actually have trigger finger.

2. Wait and See: In some patients trigger finger will go away of its own accord just by waiting and seeing what happens. Yes, I am aware that this sounds like pretty lame advice from a physio but it is also true! Sometimes after a long period of experiencing annoying clicking and catching the symptoms of trigger finger will randomly go away. So, before doing anything significant about it, it is probably best to wait and see for a good period of time.

3. Rest: for some patients it is a particular activity or task that is really irritating things and in these patients resting from that task and avoiding any irritating activities can let the tendon settle down and allow their trigger finger to heal itself.

4. Anti-Inflammatories: using some non-steroidal anti-inflammatory medication such as ibuprofen can be helpful in reducing the inflammation of the tendon and the symptoms of trigger finger. However, it is important to check with your doctor whether it is safe for you to take this medication.

5. Taping and Splinting: for some patients with trigger finger either the above options have not worked or their symptoms are too severe in which case taping up the affected finger or using a splint can help. To know how to do this you would probably need an assessment with a physio first.

6. Massage: this can occasionally be helpful for patients with trigger finger and can certainly relieve some of the symptoms. It is improtatnt to not be too aggressive initially and certainly I would recommend an assessment with a physiotherapist first in order to learn where you should massage and what techniques to employ.

7. Steroid Injections: some patients will have tried all of the above conservative options for their trigger finger with little or no success and in these cases a steroid injection may be helpful in reducing the inflamation in the tendon and sheath. This may be done in your GP surgery or it sometimes requires a referral through to a hand specialist.

8. Surgery: finally after trying all of the other options for trigger finger some patients may need to explore surgery. This is done after a referral from the GP to a hand surgeon who will decide upon teh best course of action.

Okay, I hope that you have found this article about trigger finger useful. If you have trigger finger or are wondering if you have trigger finger and would like more information then please get in touch. If needed one of our physiotherapists will be able to assess and diagnose your symptoms and help with treatment and advice.

For anyone reading: we are a home visit physiotherapy service, based in Lichfield but serving anywhere within a 20 minute drive including areas such as Sutton Coldfield, Tamworth, Cannock, Burton and Rugeley. We offer a wide range of services including paediatric physiotherapy, post-operative rehabilitation, neurological physiotherapy and neck and back pain relief. If you need further information or would like to book an appointment we can be contacted on 0788 428 1623 or via enquiries@threespiresphysiotherapy.co.uk