Finger Hand Hand Therapy Trigger Finger

Advice from a Certified Hand Therapist: Trigger Finger

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I noticed that after making a fist, when I try to straighten one of my fingers, it catches and becomes very painful. Sometimes it is necessary to take my other hand to force the finger back into a straight position.

The condition you are describing may be trigger finger (or trigger thumb), and is frequently caused by overuse. Some examples of activities that might initiate this condition are power washing a deck for several hours, using a rivet gun repetitively, leash training a dog or opening window latches that have a lot of resistance.

Why is there a hard nodule present in my palm? It’s tender to touch!

The nodule is actually extreme thickening of the tendon, and each time your tendon “triggers,” there is an inflammatory response that occurs (see diagrams below). Look at the swollen tendon in the first diagram, then take a look at the pulley in the second diagram. You will see that at some point, the nodule becomes so inflamed the tendon can’t glide underneath the pulley — that’s why it “triggers.”

Is there conservative treatment that will help this condition?

Glad you asked, because there is a cuff orthosis (see photo) that a certified hand therapist can fabricate. This does not allow your finger to move into a fist position, preventing it from “triggering.” The orthosis is a bit larger if more than one finger is involved (see photo). There was an excellent study published in 1988 in the Journal of Hand Therapy that showed that no other treatment was necessary for 73% of the patients using this conservative management approach.

In addition to wearing the orthosis, your certified hand therapist will instruct you in tendon excursion exercises, which improve the health of the tendon.

trigger finger 1 trigger finger 2

How can I find a certified hand therapist in my area?
There is a handy Find a Therapist directory on the ASHT website, www.asht.org.

Please be certain to start your treatment as soon as possible; if you have the condition for more than six months, it can be more challenging to treat!


Heidi Hermann Wright, DHS, MBA, OTR, CHT is a certified hand therapist and a member of the American Society of Hand Therapists (ASHT).

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7 Comments
  • Terri
    November 21, 2018 at 12:41 PM
    Reply

    I had surgery for trigger thumb on left thumb on Friday Nov 16th and I’m not sure if its fixed. cause thumb still stiff.
    help please

    • November 21, 2018 at 12:52 PM
      Reply

      Terri,

      We highly recommend that you contact the surgeon that performed your surgery. He/she will be able to answer any questions you have about post-surgery stiffness and recovery time.

      Sincerely,
      Staff
      American Society for Surgery of the Hand

  • Cindy
    October 21, 2018 at 9:02 AM
    Reply

    I had surgery on my right hand for a severed tendon on my pinkie. About 5 months after my surgery I developed trigger finger in my middle finger right hand. My hand has always been swollen after the surgery, it’s been 9months now and it’s still swollen stiff and tender. The cortisone injection was just a bandaid for a few weeks. I saw a hand therapist for many months. Any suggestions you might have would be appreciated.

    • Blair
      November 15, 2018 at 6:22 PM
      Reply

      Hi Cindy wondered if you have received any advise at all. I had surgery and swelling may go down if you ensure braced hand is cushioned under fingers in new arm support sling , by makeshift cushioning on base to free fingers and sling. This helps rest for sleeping, and minimises inflammation. Furthermore no fiddly use of hands replace with thumb and forefinger finger use for extra time for rest. And cream

  • loretta wilson
    September 8, 2018 at 6:20 AM
    Reply

    I had a shot in my finger yesterday to relieve my trigger finger. It is still numb . How long does that last.?

    • Laura Hamm
      November 13, 2018 at 4:51 PM
      Reply

      I had a cortisone shot in my finger joint, and it lasted almost 5 years. I suppose it depends on the severity of the trigger finger. Now the pain is back and unlocking it hurts. I’m not sure I want to get another cortisone shot, though.

  • Ms s mukerji
    May 7, 2018 at 11:38 AM
    Reply

    How hand therapy. is practised kindly let me know..for thumb trigger..

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