Stenosing tenosynovitis aka trigger finger is a painful disorder characterized by stiffness or apparent locking of the involved finger.The most commonly affected digits are the ring finger and the thumb. The condition is observed in more frequency in females especially in the age group of the 50s and 60s. The disorder gets its name from the popping sound produced when the affected finger is used. Patients suffering from the condition also frequently complain of pain that radiates towards the palm or the knuckles.
The exact etiology behind the disorder remains unclear, however, several factors have been identified that contribute to its development. A repetitive strain injury is one of the major suspects, which is proposed to cause the narrowing of the fibrous sheath in which the tendons of the digits run. Carpal tunnel syndrome and rheumatoid arthritis are two other contributing conditions linked with the disorder. Other risk factor includes diabetes, thyroid disorders, kidney diseases, and similar inflammatory disorders. The diagnosis is of clinical origin that excludes the other possible causes.
Trigger finger not only causes cosmetic deformity in the affected individuals but also predisposes them too low quality of life by hindering the hand functions. The patient suffers in smoothly performing the basic activities of life requiring active digits and hand movement.
Multiple conservative and surgical options have been proposed to tackle the conditions as trigger finger treatment. However, the majority of patients prioritize noninvasive procedures due to their affordability, low risk of complications, and ease in carrying out these therapies without much assistance at home. These include: resting the affected finger, splinting, pain management with medications, heat therapy, ultrasound devices, and steroid injections, etc. Multiple such devices have been introduced that combine these modalities and can easily be operated by the patients for instant symptomatic relief at home.
Today, we’ll be justifying the use of one such device with the help of authentic literature and research papers for non surgical treatment for trigger finger. The device in the discussion today is called the Trigger Finger Wand that combines infrared and ultrasound therapy to produce immediate results with regular use and is considered as among the best natural remedies for trigger finger. The device is complemented with a trigger finger tape that serves as a splint to stretch and support the involved finger as a non surgical treatment for trigger finger.
One of the safest and non-invasive approaches for trigger finger treatment that provide effective symptomatic relief is splinting with the help of medical tape. Restoring the anatomical alignment, the trigger finger tape stabilizes the finger and can be worn for extended periods daily. It is proposed to reduce the tendon exertion for adequate time for the synovitis around it to resolve. A study published in the Journal of Prosthetics and Orthotics showed a symptom resolution of 53% in manual work using splinting for 6 months to manage trigger finger.
Another study evaluated the effectiveness of splinting in 43 participants suffering from trigger finger. The individuals were assessed after 10 weeks of duration by two different tools i.e. stenosing tenosynovitis (SST) and Visual Analog Scale (VAS). The researchers found statistically significant improvement in patients by both standards.
A similar study combined exercise with splinting and found a 73% success rate in terms of symptomatic relief. Another clinical trial conducted in the USA found a 70% patient satisfaction rate when the affected digit was splinted at the MCP joint in 10-15 degrees of flexion.
The use of therapeutic ultrasound to manage complaints such as pain, swelling, and inflammation has been approved by the American Medical Association Council on Physical Medicine and Rehabilitation since the early 1950s. After the recent medical advancement, this modality is now even offered in portable compact devices that are readily available around the globe. Ultrasound therapy is proposed to reduce inflammation and pain and accelerate soft tissue healing when employed by patients with trigger finger. The thermal effects produced by the ultrasound upon the applied site include increased blood flow, reduction in muscle spasm, and increased extensibility of collagen fibers. Multiple studies estimate the thermal effects to occur with an elevation of tissue temperature upto 40–45°C for at least 5 minutes of use.
A clinical trial conducted in Turkey randomly selected 18 women with an inflammatory condition of hands to evaluate the effectiveness of ultrasound therapy. Three varying intensity of continuous ultrasound therapy was administered for 5 minutes, 5 days a week, for 2 weeks. The patients were clinically assessed after the completion of treatment and it was found that all participants showed statistically significant improvement in parameters such as pain and paresthesia. Thus, the research positively validates the efficacy of ultrasound therapy to treat inflammatory conditions such as a trigger finger.
Another study evaluated the efficacy of ultrasound therapy in multiple pain syndromes by using the visual analog scale (VAS), range of movement, and Likert scale. They also observed potential improvement in the participants receiving US therapy for 10 min a day for 15 sessions during 3 weeks of study.
Thermotherapy is the therapeutic application of any substance or device to the body that causes an increase in tissue temperature. It is infamous to provide analgesia and decrease muscle tonicity, along with increasing the blood flow, metabolism, and connective tissue flexibility, making it an excellent candidate to be employed to manage conditions such as trigger finger. Increased blood flow is proposed to facilitate tissue healing by supplying protein, nutrients, and oxygen at the affected site. Continuous low-level heat therapy directly on the skin is safe and therapeutically effective in treating musculoskeletal disorders. For centuries varying modes of heat therapy have been used to manage pain and inflammation in almost all fields of medicine.
A study published in 2003, determined the effectiveness of thermotherapy in managing inflammatory conditions related to tendzons and joints. The domain of interest waseffective management of pain, reduction of edema, and improvement of flexion or range of motion (ROM) and function in the subjects under study. Substantial improvement was observed in the majority of these participants, which supports the previously introduced claim.
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