Trigger finger is a painful condition that makes your fingers or thumb catch or lock when you bend them. It can affect any finger or more than one finger at a time. You can also have it in both hands. You might hear it called stenosing tenosynovitis. When it affects your thumb, it’s called trigger thumb

A trigger finger, sometimes referred to as a trigger thumb or stenosing tenosynovitis, can occur if one of three things happen: 

1. The tendon enlarges (does not fit through pulley well); 

2. The lining increases in thickness (does not fit through pulley well); 

3.The pulley becomes thicker (the opening for the tendon gets smaller). The finger tendon and pulley system is designed to have the exact right sizes of each structure. The change in size of any of the important finger structures can cause problems. If the tendon becomes tight within the pulley, the lining gets squeezed and reacts with thickening. The bigger lining then produces more fluid. And the higher volume of fluid increases pressure. The undersurface of the pulley can also change and thicken. This thicker pulley causes friction on the moving tendon. This makes it difficult for the tendon to move back and forth 

Symptoms

Signs and symptoms of trigger finger may progress from mild to severe and include:

 1. Finger stiffness, particularly in the morning

 2. A popping or clicking sensation as you move your finger 

3. Tenderness or a bump (nodule) in the palm at the base of the affected finger 

4. Finger catching or locking in a bent position, which suddenly pops straight 

5. Finger locked in a bent position, which you are unable to straighten

Causes

Trigger fingers are more common with certain medical conditions. Rheumatoid arthritis, gout and diabetes are risk factors for this condition. Repeated and strong gripping may lead to the condition. In most cases, the cause of the trigger finger is not known

Risk factor

 Things that make you more likely to have trigger finger include:

  • Age. It usually shows up between ages 40 and 60.
  •  Sex. It’s more common in women than men. 
  • Health conditions. Diabetes, gout, and rheumatoid arthritis can lead to trigger finger. 
  • Job. It’s common among farmers, industrial workers, musicians, and anyone else who repeats finger and thumb movements
  • Surgery for carpal tunnel syndrome. It’s most common in the first 6 months after your operation

Trigger Finger Treatment 

Treatment depends on how severe your symptoms are. Most of the time, you’ll start with: 

  • Rest. Try not to move the finger or thumb. You may need to take time away from the activity that’s causing the problem. If you can’t quit, you might try padded gloves 
  • Splints. Your doctor can give you one designed to keep your finger still. 
  • Stretching exercises. These gentle moves may ease stiffness and improve range of motion. 
  • NSAIDs. Your doctor may suggest over-the-counter drugs that fight inflammation, like ibuprofen or naproxen. 
  • Steroid injections. They might give you a steroid shot into the tendon sheath. It can keep your symptoms at bay for a year or more, but you could need two shots to get results.

If the condition does not respond to non-surgical treatments or continues to recur, surgery may be recommended. The surgery is done under local anesthesia (you will be awake but may be sedated for comfort) and does not require a hospital stay.

During the surgery, a tiny cut is made in the sheath through which the tendons pass. Cutting the sheath widens the space around the tendons of the affected finger(s) or thumb. This allows the tendon to slide more easily through the sheath.

 The surgery helps restore the affected finger(s) or thumb’s ability to bend and straighten without pain or stiffness.

Recovery time following surgery is typically only a couple of weeks. However, recovery times vary, depending on your age, general health, and how long the symptoms have been present.

PHYSIOTHERAPY TREATMENT

physical therapists may recommend simple stretching exercises to help alleviate the pain and stiffness associated with trigger finger or trigger thumb

Do these exercises three to five times each day, to begin with, building up to hourly.

1. FINGERTIP BEND

 To perform the fingertip bend exercise, hold the finger just below the top joint. Then bend the tip of the finger while keeping the rest of the finger still.

2. Tip and middle joint bend 

Below are some steps for performing the tip and middle joint bend exercise. 

Hold the finger just above the knuckle at the base of the hand. 

Bend the tip and middle joints of the finger while keeping the rest of the finger still.

 Unbend the finger back to the starting position.

3. Passive wrist stretch 

Below are some steps for performing the passive wrist stretch. 

Place the palms together in front of the chest, just below the chin. 

Slowly lower the hands to the waistline, until feeling a stretch in the wrists and fingers. 

Hold the position for 10 seconds .Keeping the palms together, move the hands back up to the starting position.

4. Clenched wrist bend 

Below are some instructions for performing the clenched wrist bend exercise. 

Loosely clench the fist, and place it on a table with the thumb facing upward. 

Bend the wrist and fingers towards the body. 

Hold the stretch for 2 seconds. Return the wrist to its starting position. 

Repeat 10 times on each side.

5. Side to side wrist bend 

Below are some steps for performing the side to side wrist bend exercise. 

Place the hand palm down on a table, with the wrist straight. 

Bend the wrist as far as possible to the left. Hold for 2 seconds. 

Move the wrist back to the center.

Bend the wrist as far as possible to the right. 

Hold for 2 seconds. 

Move the wrist back to the center. 

Repeat 10 times on each side.

6. Hand turn

 Below are some steps for performing the hand turn exercise. 

Place the hand on the table, with the palm facing downwards. 

Slowly turn the palm upward, as far as is comfortable. Hold for 2 seconds. 

Turn the hand back over so that the palm is facing downward. Repeat the exercise 10 times.

7. Hand clench

 Below are some instructions for performing the hand clench exercise. 

Rest the outer side of the hand on a table, with the thumb facing upward. 

Keep the wrist straight .

Clench the hand into a loose fist. 

Hold for 2 seconds. Unclench the fist, and straighten the fingers. 

Clench and unclench 10 times

8. Finger curl 

When performing the finger curl exercise, a person may find it easier to rest their elbow on a table. They should then follow the steps below. 

Begin with the palm facing toward the body.

 Clench the hand into a loose fist. 

Slowly uncurl the thumb and fingers until they are all fully extended .

Hold for 2 seconds Curl the fingers and thumb back into a loose fist. 

Curl and uncurl the thumb and fingers 10 times.

9. The bent finger 

The bent finger exercise can help strengthen the tendon in the thumb. To perform this exercise, follow the steps below. 

Bend the thumb inward toward the palm until it touches the tip of the index finger. 

Hold for 10 seconds.

 Repeat the exercise on the middle, ring, and little finger .People should repeat the exercise three to four times per day.

10. The ball squeeze 

The ball squeeze exercise can help alleviate tendonitis of the thumb. To perform the exercise, hold a small ball in the palm and gently apply pressure to the ball with the fingertips. A person can strengthen the thumb muscle further by applying extra force. People should perform the exercise three to four times per day.

Prevention

Some ways to help prevent trigger finger include:

  • Avoiding repetitive grasping or gripping motions
  • Avoiding the use of vibrating hand-held machinery
  • Avoiding any activity that worsens symptoms of trigger finger