Doctor... I’ve Been Diagnosed With Trigger Finger... What Is It? By Nathan Wei At Isnare.com Ezine Articles

Trigger finger is an extremely condition. A patient with trigger finger will notice that their finger catches either when they try to bend it or when they try to straighten it. The finger catches and refuses to go any further. The medical term for trigger finger is stenosing tenosynovitis. The condition can affect any finger including the thumb.

The reason trigger finger develops is because of the structural makeup of the fingers and hand. Each finger has tendons that attach to the end of the finger. The other end of these tendons is attached to muscles that pull the tendons. The tendons glide within a tunnel- a sheath that is lined with synovial tissue- the same kind of tissue that lines joints.

The sheath functions much like the guides on a fishing rod through which the tendon passes. The tendons normally glide very smoothly through the synovial sheath.

When the tendon develops a nodule or swelling of its sheath lining, it has difficulty passing through the sheath. The "popping" or "catching" sensation in the finger or thumb comes from the tendon "squeezing" through the tendon sheath. The swollen tendon is irritated more as it has to be squeezed through the sheath, producing more swelling. This becomes a vicious cycle where there is sticking (triggering) of the tendon within the sheath, inflammation, and swelling. Sometimes the finger will become stuck (locked) and it may be hard to straighten or bend the finger.

There are many causes for trigger finger. For example, diseases such as rheumatoid arthritis, gout, pseudogout, psoriatic arthritis, and diabetes can create swelling around the tendons which then leads to the irritation, inflammation, swelling of the tendon and tendon sheath. Trauma is another cause.

The goal of treatment is to eliminate the catching or locking and allow movement without discomfort. To do this the swelling within the tendon sheath must be reduced to allow smooth gliding of the tendon. Wearing a splint or taking anti-inflammatory medication by mouth, or injection of glucocorticoid (cortisone) into the tendon sheath, are methods to reduce the swelling. Use of ultrasound guidance is critical when injecting the tendon sheath in order to avoid injection of steroid directly into the tendon, leading to more damage.

Instruction in hand mechanics to reduce the negative impact of repetitive motion is also helpful.

Surgery may be recommended if injections fail. This surgery is usually performed on an outpatient basis. Most often it is done using local anesthesia, but a regional block (where only the arm is numbed) or a general anesthetic may be used. The surgery opens the tendon sheath which gives the tendon more room to glide.

Active motion of the finger is generally begun immediately after surgery. Normal use of the hand can be resumed once healing has taken place.

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