Trigger Finger - Is It Really All That Common?

Carpal Tunnel Syndrome (CTS) is the most widely recognized form of Repetitive Strain Injury (RSI), but Trigger Finger is catching up fast, becoming all too common among society and affecting the youth and elderly in ever-increasing numbers. If the rising numbers keep on track, Trigger Finger may be recognized along with Carpal Tunnel Syndrome as having achieved epidemic proportions.

Trigger Finger On The Rise

Prior to the 1990's, Trigger Finger seemed to affect a small number of the elderly that had experienced some form of direct trauma or excessive strain to one or possibly several fingers. Trigger Finger was more prevalent in those that were already suffering with Osteoarthritis in the affected hand, making many healthcare professionals to believe that Trigger Finger was a byproduct of Osteoarthritis. But within the past 5-years, the age of those suffering from Trigger Finger became much “younger” while the overall number of individuals with the disorder increased. The belief of a direct correlation between those suffering with Osteoarthritis and Trigger Finger seems to be reducing in popularity as many of those suffering with Trigger Finger do not have Osteoarthritis, but instead, are involved in high-risk tasks that are already associated as the causative factor in many types of Repetitive Strain Injuries.

Injuries resulting from repeated motion (repetitive / cumulative trauma disorders -- CTD's) are growing. According to recent annual statistics from the U.S. Survey of Occupational Injuries and Illnesses, over 302,000 CTD's account for nearly two-thirds all of workplace-related illnesses.

Ergonomic disorders are the fastest growing category of work-related illness. According to the most recent statistics from the U.S. Bureau of Labor Statistics, they account for 56 percent of illnesses reported to the Occupational Safety and Health Administration.

Trigger Finger – Recognized as a Repetitive Strain Injury

Now that Trigger Finger is rearing its head in the workplace with increased intensity, it has been added to the growing list of debilitating Repetitive strain Injuries. Trigger Finger now joins the ranks of Tendonitis, Carpal Tunnel Syndrome, Epicondylitis, Cubital Tunnel Syndrome, DeQuervain's and the many other debilitating workplace disorders affecting the upper extremity. So, what is Trigger Finger, how is it recognized and what are its symptoms?

Trigger Finger Explained

Trigger Finger is a form of overuse injury affecting any of the fingers (1-5) with symptoms ranging from a painless annoyance with occasional snapping/jerking of the finger(s), to severe dysfunction and pain with continuous locking of the finger(s) in a flexed downward / forward position into the palm of the hand.

The occurrence of this injury usually results from overuse of the flexor muscles/tendons and the formation of an adhesion or fibrotic nodule on the tendon. If left untreated, the adhesion/nodule becomes larger, therefore creating a conflicting ratio between the size of the tendon and the size of the entrance of the tendon sheath. In most cases, if the adhesion/nodule is not treated, it can continue to increase in size (Depending on activity/use of the affected finger) to the point where it still has the ability to pass into and through the tendon sheath when flexing the finger, but becomes stuck and cannot move back through the tendon sheath when trying to extend/straighten the finger, thus causing the finger to lock in the flexed forward / downward position.

The Trigger Finger Solution

Because Trigger Finger consists of an adhesion, nodule, and scar tissue buildup on the tendon due to excess strain, overuse, or direct trauma to that specific location on the tendon, it should be treated with stretching and strengthening exercises in order to break down the adhesion on the affected tendon. By breaking down the adhesion on the affected tendon, it reduces in size and slides through the pulley system in a normal manner, no longer “catching” and locking into the downward flexed position. (There is also a “thinning” of the tendon, which helps reduce the overall size of the tendon and nodule, therefore allowing it to pass through the tendon sheath with greater ease.) Creating strength in the opposing finger extensor tendons is very important as it allows the finger to return to an extended position in a more appropriate manner. This is where muscle balancing comes into play. By creating equality of tendon length and strength on both sides of the finger joint, individuals can help prevent the onset of Trigger Finger and/or keep it from re-occurring in the future.

Conservative therapy utilizing stretches and exercises has been highly effective, providing long-term and permanent relief. For those wanting to avoid surgery and for those where surgery was not effective in eliminating the condition, stretch and exercise therapy is the solution to both preventing and rehabilitating the devastating symptoms associated with Trigger finger.