Trigger finger treatment

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit

The medical term for trigger finger is “stenosing tenosynovitis.” This is a form of tendonitis that affects the tendons in the hand that flex the fingers.

The tendons work like long ropes connecting the muscles of the forearm with the bones of the fingers and thumb. The tendons travel through sheaths lined with synovium, the same tissue that lines joints. The tendons and the sheaths have a lubricated lining that allows easy gliding inside the pulleys.

Trigger finger/thumb occurs when the tendon develops a nodule or swelling of its lining. When the tendon swells, it must squeeze through the opening of the tunnel (known as the flexor sheath). This causes pain, popping, or a catching feeling in the finger or thumb. When the tendon catches, it produces inflammation and more swelling. Sometimes the finger becomes stuck (locked) and is hard to straighten or bend.

Causes for this condition are not always clear. Some medical conditions such as rheumatoid arthritis, gout, and diabetes may be associated with trigger finger symptoms.

Trigger finger may start with discomfort felt at the base of the finger or thumb. A thickening may be found in this area.

The goal of treatment in trigger finger 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. The wearing of a splint, taking anti-inflammatory medication by mouth, and an steroid injection 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. This surgery is performed as an outpatient. The goal of surgery is to open the first pulley so the tendon will glide more freely. Normal use of the hand can usually be resumed once comfort permits. Some patients may feel tenderness, discomfort, and swelling around the area of their surgery. Hand therapy is often recommended after surgery to improve use.

A more recent development is the use of percutaneous hydrodissection release. In this procedure, ultrasound guidance is used to introduce a small needle into the tendon sheath. A large amount of fluid is then injected to open the tendon sheath... similar to how an angioplasty opens a coronary artery. This hydrodissection procedure is much less invasive than the standard surgical procedures used for trigger finger.

For more information about this procedure, go to:
Arthritis Treatment Center

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