This is very a common medical disorder that restricts the movement of a finger. The moment you make an attempt to straighten out your finger, it involuntarily locks or catches before it pops out straight.
This condition tends to affect the tendons that are present in the fingers or thumb.
Anatomy
The sheath of the tendon remains attached to the bones of the finger and retains the tendon of the flexor in position as it moves. The tendons are the tissues that link the muscles to the bone. The moment muscles contract, the tendons are pulled on bones and this is what results in the movement of some parts of the body.
The muscles that are responsible for the movement of fingers, including the thumb are found in the forearm. The Long tendons technically known as flexor tendons spread out from the muscles all through the wrist. They are attached to the smaller bones of the thumb and fingers.
The flexor tendons are the ones that control the motion of the fingers as well as the thumb. Once you curve or straighten out any of your fingers, the tendon of the flexor slips through a fitting tunnel, referred to as the tendon sheath. This sheath holds the tendon in its position next to the bones.
Description
The flexor tendon may end up being irritated in the process of sliding through the sheath. As irritation keeps increasing, the tendon may gradually thicken resulting to formation of nodules which increases the difficulty of its passage through the channel. The sheath of the tendon may thicken too and thus, resulting to constriction of the tunnel, making it smaller. In case you have the trigger finger condition, the tendon temporarily sticks at the opening of the tunnel of the tendon sheath once you attempt to straighten out the finger. You may experience a pop when the tendon slides through the tightened region and your finger may shoot out suddenly.
The nodule formed on the flexor tendon will strike the sheath of the tunnel, leading to difficulty in straightening of the finger.
Cause
The primary cause of this trigger finger condition is still not clearly known. However, a variety of factors put individuals at greater possibility for developing it.
This condition is more prevalent in women than in men.
It often occurs in people with the ages of between 40 and 60 years.
Trigger fingers also frequently affect people with particular medical problems, for instance rheumatoid arthritis and diabetes.
This condition may come about after strenuous activities to the hand.
Symptoms
The symptoms of trigger finger typically begin even without any damage, however they may come after a period of hefty use of the hand. Some of the symptoms include:
- A gentle lump inside your palm
- Exploding sensation within your finger or joints of the thumbs
- Swelling
- Soreness when straightening or bending your finger
- Rigidity and popping sensation worsen especially after prolonged inactivity, for example after you wake in the morning.
- From time to time, when the tendon eventually breaks free, you may feel like the joint of your finger is dislocating. In the severe trigger finger cases, the finger fails to straighten, even with assistance. Sometimes, more than one finger may be affected.
Nonsurgical Treatment
Sufficient Rest
If the symptoms are somewhat mild, just giving the finger enough rest may be a sufficient solution to the problem.
OTC Medications
Over-the-counter (OTC) pain relief treatments, for example acetaminophen and (NSAIDS) non-steroidal anti-inflammatory prescriptions can be used to get rid of the pain.
Injection of Steroids
Your medical specialist may decide on injection of a corticosteroid (a very potent anti-inflammatory medication) in the tendon that has the irritation. Sometimes, this recovers the problem but only temporarily, then an additional injection is required. If both the administered injections are unable to provide a solution for the problem then the best solution is surgery.
If you have been having trigger finger for quite some time or have a medical condition like diabetes then there is a low probability of the injections working.
Surgical Treatment
The trigger finger condition is not very dangerous. The choice to have the surgical operation is personal, grounded on the severity of your symptoms and whether the non-surgical options have not been successful. Also, if your finger sticks in a curved position, your medical expert may vouch for a surgical procedure to avoid long-lasting stiffness.
Surgical Procedure
The aim of surgery is widening of the tunnel’s opening to enable easier sliding of the tendon. Usually this is done on a basis of outpatients: you will not be required to stay overnight at the clinic or hospital. Most individuals are injected a local anesthetic to make the hand numb for the operation.
A small incision is made in the palm where the surgery is going to be performed. The sheath of the tendon’s tunnel is cut. After the healing, the sheath loosens giving the tendon more room for movement.
The sheath of the tendon is cut during the surgery
Complications
The trigger finger surgical release operation has a negligible risk factor, but just like any surgical operation, there is always a potential risk:
- Inadequate extension as a result of persistent tightness of the sheath of the tendon
- Persistent triggering because of partial release of a part of the tendon sheath
- Bowstringing due to too much release of the tendon sheath
- Infection
Recovery
Most individuals have the ability to move their affected finger straightaway after surgery.
Soreness in your palm occurs and regular raising of your hand a distance above the heart could help in reduction of swelling and the pain.
Usually full recovery occurs within a few weeks, however, it may take as long as 6 months for all stiffness and swelling to disappear.
If your finger was a little stiff even before operation, physical therapy and some finger workouts may assist in loosening it up.
