Dr. Sameer Puri answers your most important questions about stenosing tenosynovitis, also known as trigger finger.
My doctor told me I might have a “trigger finger.” What is that?
“Trigger finger,” or stenosing tenosynovitis, is a condition that causes pain, locking, popping or clicking of the fingers or thumb when the hand is opened or closed.
What causes trigger finger?
Muscles in your forearm attach to tendons that run all the way to the bones at the ends of your fingers. These muscles help you bend your fingers into a fist. In the hand, the tendons are held close to the bone by pulleys. If the pulleys become too tight or thick, or the tendon gets swollen, the tendon can get stuck. If the tendon cannot glide freely, trigger finger occurs.
What are some of the symptoms of trigger finger?
In its early stages, trigger finger can cause pain. Usually, it is tender on your palm where the finger joins the hand. Sometimes, you feel the pain further along or even on the back of the finger. You might feel like your hands or fingers are stiff or swollen. As it progresses, the tightness can cause the tendon to catch as it tries to glide, leading to a painful snapping sensation when making a fist or opening the hand. Eventually, the finger can get stuck where it is, making it really hard either to straighten or to bend it.
The symptoms are often worst in the mornings immediately after waking up and can occur in any of the fingers or thumbs.
Why did I get trigger finger?
No one knows exactly why this happens. People who have diabetes or other inflammatory conditions seem to be affected more frequently, but it can happen to anyone.
How can you treat trigger finger?
If caught in the early stages, a splint or oral anti-inflammatory medicines may be able to calm down the symptoms. After this, the first line of treatment is usually a small steroid injection into the sheath of the tendon. This helps to decrease the swelling and allow the tendon to glide smoothly again.
If you have had injections that did not work in the past, your symptoms have been happening for a long time, or your finger is stuck in place, your hand surgeon might discuss surgery with you. This involves releasing the pulley that is blocking the tendon(s) from gliding. Most patients are allowed to move the finger and use the hand immediately after surgery. In some cases, your doctor may recommend hand therapy after surgery, but many patients will not require formal therapy to regain their motion.
Sameer Puri, MD is an Assistant Professor in the Department of Orthopaedic Surgery at Loyola University Medical Center in Maywood, IL, specializing in hand and upper extremity surgery. He completed his orthopeadic surgery training in Boston at the Tufts Combined Orthopaedic Residency, and completed subspecialty training in hand and upper extremity surgery at the Hospital for Special Surgery in New York.