(Stenosing Tenosynovitis; Volar Flexor Tenosynovitis)En Español (Spanish Version)
Trigger finger is an inflammation of the synovial sheath that encloses the flexor tendons of the thumb and fingers. Tendons are the cords that connect bones to muscles in the body. Usually, tendons slide easily through the sheath as the finger moves.
In the case of trigger finger, however, the synovial sheath becomes swollen and the tendon cannot move easily through small pulleys in the finger, causing the finger to remain in a flexed (bent) position. In mild cases, the finger may be straightened with a pop, like a trigger being released. In severe cases, the finger becomes stuck in the bent position. Usually this condition can easily be treated; contact your doctor if you think you may have trigger finger.
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Often, the cause of trigger finger is unknown. However, many cases of trigger finger are caused by one of the following:
A risk factor is something that increases your chance of getting a disease or condition.
The following factors increase your chance of developing trigger finger:
- Age: 40 to 60
- History of repetitive hand motions for work or play
- Sex: female
History of certain diseases:
- Rheumatoid arthritis
If you experience any of these symptoms do not assume it is due to trigger finger. Some of these symptoms may be caused by other health conditions. If you experience any one of them for a period of time, see your physician.
- Finger or thumb stiffness
- Finger, thumb, or hand pain
- Swelling or a lump in the palm
- Catching or popping when straightening the finger or thumb
- Finger or thumb stuck in bent position
Your doctor will ask about your symptoms and medical history, and perform a physical exam. The physical exam may include:
- Asking you to move the affected finger or thumb
- Feeling the hand and fingers
For severe cases of trigger finger, your doctor may refer you to a hand specialist.
Talk with your doctor about the best treatment plan for you. The goals of treatment for tenosynovitis are to reduce swelling and pain and to allow the tendon to move freely with the tendon sheath. Treatment options include the following:
Stopping movement in the finger or thumb, sometimes with the help of a brace or splint, is often the best treatment for mild cases of trigger finger. Rest may be combined with stretching the muscle tendon unit involved.
Several medications are used to treat tenosynovitis. These include:
- Corticosteroids, given as an injection into the synovial tendon sheath to reduce swelling of the tendon sheath
Nonsteroidal anti-inflammatory drugs (NSAIDs) to help reduce inflammation and pain:
- Ibuprofen (Advil, Motrin)
- Naproxen (Aleve, Naprosyn)
For severe cases of trigger finger that do not respond to medications, surgery may be used to release the tendon pulley of the finger from a locked position and to allow the tendon to move freely through the sheath. This surgery is usually performed on an outpatient basis and requires only a small incision in the palm of the hand.
The most important action you can take to prevent trigger finger is to avoid overuse of your thumb and fingers. If you have a job or hobby that involves repetitive motions of the hand, you can take the following steps:
- Adjust your workspace to minimize the strain on your joints
- Alternate activities when possible
- Take breaks throughout the day
American Academy of Orthopaedic Surgeons
American Society for Surgery of the Hand
The Arthritis Society
BC Health Guide, British Columbia Ministry of Health
Trigger finger. DynaMed website. Available at: http://www.dynamicmedical.com/dynamed.nsf?opendatabase . Accessed September 5, 2005.
Trigger finger. MayoClinic.com website. Available at: http://www.mayoclinic.com/invoke.cfm?id=DS00155 . Accessed September 5, 2005.
What is trigger finger? The Indiana Hand Center website. Available at: http://www.indianahandcenter.com/medical_trigger.html . Accessed September 5, 2005.
Last reviewed January 2008 by Robert Leach, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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