February 28, 2017
Hand and finger pain

  • What it is: Stenosing tenosynovitis – more commonly known as “trigger finger” – is a condition that involves one of your fingers getting “stuck” in a bent position. Often the affected finger will straighten back out with a “snap” – kind of like a trigger being pulled and then released (hence the name).
  • What causes it: Trigger finger occurs when the space within the sheath that surrounds the tendon in the affected finger becomes narrower due to inflammation.
  • Who’s at risk for developing it: Individuals who have jobs (or hobbies) that require the need for repetitive gripping actions are at a higher risk for trigger finger. The condition is more common in females and is a concern for anyone who has diabetes or rheumatoid arthritis.
  • What are the symptoms associated with it: Symptoms associated with trigger finger can range from stiffness of the finger for several hours after waking; feeling as though the finger is “catching” when it is bent, and even being unable to straighten the finger altogether.

Now that we have a basic knowledge of what trigger finger is and what causes it let’s discuss some of the ways that orthopaedic surgeons can treat the condition. It’s important to note that there are a variety of treatments – ranging from conservative (medication, rest, etc.) to more invasive (surgery, injections, etc.) and that these treatments can and will vary depending on both the severity and duration of symptoms.

Some of the most common conservative/noninvasive treatments for trigger finger include:

  • Rest – Resting the affected finger(s) for at least three to four weeks; this means avoiding any activity that involves repetitive gripping or grasping motions, as well as avoiding the use of any vibrating machinery.
  • Ice and/or heat – Some patients find that icing the palm of the affected hand several times a day helps; others express relief with warm water soaks – especially right after waking.
  • Stretching exercises – Your orthopaedic surgeon and/or physical therapist may very well recommend some gentle stretching exercises to help maintain finger mobility.
  • Splinting – Some patients benefit greatly from wearing a splint at night to help keep the affected finger extended which, in turn, helps to rest the tendon (and keeps you from bending your finger while sleeping). Splints are typically worn for up to six weeks.

Non-steroidal anti-inflammatory medications like Advil, Motrin, and Aleve may be helpful in regards to pain reduction but probably won’t do much to relieve the tendon sheath swelling.

If none of the more conservative treatments work or your symptoms are severe, your orthopaedic surgeon may suggest some slightly more aggressive forms of treatment, including:

  • Steroid injections – This involves injecting a steroid medication directly into (or very near to) the tendon sheath. The goal of steroid injections is to reduce inflammation and allow the tendon to glide freely within the sheath once again.
  • Percutaneous release – This is where your orthopaedic surgeon would first numb your hand/palm and then insert a needle into the tissue that is surrounding the affected tendon. The goal of this procedure is to break apart the structures that are blocking the tendon’s ability to move freely.
  • Surgical intervention – Trigger finger release surgery involves your orthopaedic surgeon making a small incision towards the base of your affected finger(s), allowing direct access to the tendon sheath. Then the constricted area can be cut open to release the sheath in that area.

Regardless of the treatment, the orthopaedic surgeons and physical therapists here at Prairie Orthopaedic are dedicated to helping our patients achieve the best possible outcome for their situation!

TAGS orthopaedics , physical therapy. , surgery , trigger finger