Stenosing tenosynovitis, commonly known as trigger finger or trigger thumb, is caused by the tendons that bend the finger catching or sticking within an interal tunnel at the base of the finger. The cause for this condition is not always clear. The medical conditions of rheumatoid arthritis, gout, and diabetes may be associated with trigger finger/thumb symptoms. Triggering may affect more than one digit.
Symptoms of Trigger Finger
Triggering may start with discomfort felt at the base of the finger or thumb and a thickening may be found in this area. Swelling of the tendon prevents it from gliding smoothly through the surrounding sheath at the base of the finger producing pain, “catching” or sticking of the digit on movement. This is often worse on waking and it may be very difficult or painful to straighten the digit from the flexed position.
Treatment of Trigger Finger
The goal of treatment is to eliminate the catching or locking and allow full movement of the finger or thumb without discomfort. Swelling around the flexor tendon and tendon sheath must be reduced to allow smooth gliding of the tendon. An injection of steroid into the area around the tendon may be recommended to reduce swelling. Treatment may also include changing activities to reduce swelling.
If non-surgical forms of treatment do not improve symptoms, surgery may be recommended. The goal of surgery is to divide the sheath surrounding the tendon at the base of the finger to allow the tendon to glide more freely. Active motion of the finger generally begins immediately after surgery. Normal use of the hand can usually be resumed once comfort permits. Some patients may feel tenderness, discomfort, and swelling around) the area of surgery longer than others. Occasionally, hand therapy is required after surgery to regain better use.