Trigger finger, also known as stenosing tenosynovitis, is a condition that affects the fingers and thumb tendons making it hard to bend or stretch them due to irritation or swelling of the tendon sheath lining preventing functionality.
This irritation can result in a very painful clicking or snapping feeling when bending or straightening the affected finger or thumb, and also stiffness and locking of catching through the joint.
Importance of Trigger Finger Test
A trigger finger test is essential for diagnosing the condition. It helps medical professionals assess smooth finger movement and detect any catching, locking, or snapping sounds.
Timely diagnoses and treatment are essential to prevent lasting effects, for a patient to recover better.
Anatomy of the Hand
The human hand is a fairly complicated structure with smooth movement and flexibility. This functionality greatly depends on the tendons and pulleys in the hand. The tendons flex and extend the fingers and thumbs while the pulleys, which are bands of tissue that keep them next to finger bones ensuring they slide properly, help hold them in place.
The outside lining of flexor tendons bending fingers and thumbs is called tenosynovium. These pulleys consist of a series of thick, soft tissue membranes.
How Trigger Finger Occurs
Stenosing tenosynovitis, or trigger finger, is an inflammation of the tendon sheath that causes it to thicken and make gliding through the pulleys difficult. Reasons are:
The tendon becomes larger (does not pass through the pulley easily).
The lining thickens ( does not slide through the pulley well).
When the tendon tightens within the pulley, it squeezes the lining, causing it to thicken. The larger lining leads to the release of more fluid, resulting in elevated pressures. There is also a possibility of change and thickening of the undersurface of the pulley that results in dragging on the moving tendon. This prevents the tendon from moving front and back, resulting in trigger finger symptoms.
Symptoms of Trigger Finger
Common Symptoms of Trigger Finger
- Finger locked in a flexed position
- Stiffness, especially in the morning gets better with use.
Factors That May Lead to Development Trigger finger
- Repeated grasping for example, in some occupations and hobbies that involves repetitive hand use with prolonged gripping.
- Some medical conditions such as diabetes, hypothyroidism, rheumatoid arthritis, and gout.
- Gender: Women are more likely to have trigger finger.
Diagnosis of Trigger Finger
A doctor typically makes a trigger finger diagnosis through a physical examination of the hand. During the examination, the doctor will look for the following:
- Stiffness, especially in the morning, which improves with use
The doctor may also ask about any specific activities that are more challenging to accomplish, like buttoning a shirt or squeezing a gas pump, for example. They may also grade the severity of the trigger finger on a 5-level scale, from Grade l (least severe) to Grade lV (most severe).
In some cases, the doctor may order imaging tests, such as an X-ray or ultrasound, to rule out other conditions or to confirm the diagnosis. However, a trigger finger test is usually a physical hand examination and discussing the patient’s symptoms
Treatment Options for Trigger Finger
A diagnosis of trigger finger is usually established by a physician during a physical examination of the hand. During the examination, the doctor will look for the following:
Stiffness, especially morning stiffness that improves with use
The doctor could also inquire about any activities that are harder to perform, such as fastening a button on the shirt or pressing the gas pump among others. They might also score the degree of trigger finger on a scale from I (least severe) to Grade IV (most severe).
On many occasions, the physician may request imaging studies like X-ray or ultrasound to exclude other pathologies or to confirm the diagnosis. Nevertheless, a trigger finger test is usually a manual physical hand examination and talking through the patient’s symptoms
Most cases of trigger finger can be effectively managed without surgery with conservative measures, including:
Changing activity so that the tendon can rest
Corticosteroid injections, deemed safe and effective for treating trigger fingers in numerous patients, should not be administered in the same finger more than two or three times.
A certified hand therapist may also recommend therapy, involving physiotherapeutic measures like applying heat, massaging, stretching the fingers, and manipulating the finger joints.
If non-operative measures fail, prompt surgical intervention is crucial for trigger finger release (or A1 pulley release). This is necessary to prevent acute stiffening of the finger or thumb. Surgeons perform procedures to relieve the A1 pulley, ensuring that the flexor tendon can slide smoothly through the sheath and eliminate any clicking or snagging sensations.
Preparing for a Trigger Finger Test
- Bring something with you to the appointment.
- All relevant medical documents or test results
- A list of current medications
- Questions or issues to be addressed with the doctor
What to Wear
Easy access to the hand for the physical examination comfortable clothes
What one should expect during the test.
A physical palpation test to assess lumps in the palm and smooth movement, additionally noting catching, locking and snapping sounds during finger movements.
Diagnose and treat trigger finger early to prevent permanent stiffness of the fingers and achieve a good recovery. If you experience any indication of trigger finger, seek immediate medical attention to explore therapeutic options and prevent the condition from worsening.