Stenosing tenosynovitis, commonly known as ‘trigger finger’ occurs when the tendon responsible for finger or thumb movement becomes unable to slide smoothly in and out of the sheath surrounding it. It can affect any finger with the primary symptom presenting as a finger catching or locking in a bent position.
Simplified, it is inflammation of a tendon that causes abnormal narrowing or contraction. Trigger finger is painful, but treatable. It involves flexor tendons which have a lining located on the exterior called tenosynovium. The lining is wrapped with layers of thick, soft tissue called pulleys. If the tendon expands, the lining becomes too thick or the pulley becomes thicker it spells trouble for fingers to function properly.
Imagine a bucket descending into a well to retrieve water utilizing a pulley system. The idea is for the bucket to move down the shaft of the well with ease. Everything runs smoothly unless there is a knot or a catch in the rope that halts or stalls motion.
Trigger finger is more complicated than a bucket inside a well, but the analogy works. When something happens to the tendon it dramatically affects the pulley system in the finger and locks up like the rope inside a well. In a severe case of trigger finger, fingers become so stuck that a person’s free hand or someone else’s assistance may be needed to help straighten fingers or a thumb.
Symptoms may occur before a finger or thumb locks up. People often experience soreness at the base of a finger or where the thumb meets the palm of the hand. It may also be more present after tightly holding or constantly gripping objects. Pain and stiffness can be a precursor when bending fingers or thumbs. And sometimes a lump can appear if the hand is swollen or tender.
What causes trigger finger is somewhat mysterious, but there are a variety of factors that may increase chances of developing the issue; diabetes, rheumatoid arthritis, age (mostly older adults over 40), gout and forceful use of the fingers and thumb.
Non-Surgical treatment is available and is focused on reduction or elimination of the swelling, catching/locking to restore pain-free movement. Dupuytren’s Contracture can mimic trigger finger, so it is important to visit with a specialist to receive a proper diagnosis and prevent further issues.
Surgery involves a trigger finger release which releases the A1 pulley – the A1 pulley is focused on tendon movement. When the pulley is released, the flexor tendon can move more freely through the tendon sheath, which removes the clicking/catching sensation. Trigger finger release is an outpatient procedure.
If you have questions or concerns regarding trigger finger or other orthopedic matters, please do not hesitate to reach out to schedule an appointment with a specialist at McBride. Relief is available for those suffering from pain, stiffness and reduced mobility.
