Trigger Finger

gachette

Description

The flexor muscles of the fingers are located in the forearm and their tendons attach to the small bones of the fingers and thumb. When we bend or straighten our fingers, the tendons of the flexors slip into a small tunnel called the tendon sheath, which keeps the tendon in place near the bones. The tendon of the flexors may gradually become irritated under this tendon sheath. This will gradually result in a thickening of the tendon and the probable appearance of nodules causing a much more difficult passage of the tendon in the tunnel. In the presence of a finger (or thumb) trigger, the tendon will be temporarily blocked during passage through the tunnel (tendon sheath) during flexion / extension of the finger.

Presentation

  • Presence of a sensitive bump in the palm of the hand.
  • Swelling.
  • Sensation of blocking and sudden unblocking during movement of flexion / extension of the finger.
  • Pain during flexion / extension of the affected finger.

Causes

  • Cause unknown.
  • More common in women.
  • More common among 40 to 60 year olds.
  • People with diabetes or rheumatoid arthritis are more at risk.

Treatments

  • If very light, rest can help.
  • Treatment of Active Release Techniques (ART) or Graston to break muscle and tendon adhesions.
  • Use of neurocryotherapy, ice or NSAIDs to decrease inflammation or pain.
  • Stretching exercises and modification of activities associated with the condition.
  • Injection of cortisone in cases refractory to conservative treatment.
  • Surgery in cases refractory to cortisone.

Prognosis

  • In mild to moderate cases, improvement is often noted after 4-6 weeks of conservative treatment.
  • In cases where surgery is required, most cases will regain normal movement immediately after surgery but a period of 6 months may be required so that the swelling and stiffness completely disappear.