Trigger Finger"Trigger finger" sounds like a malady that might affect gunslingers or hunters. In fact, this common condition results in a finger bent as if to pull a trigger. People over 40 years of age with are especially at risk to develop this condition. A history of diabetes or rheumatoid arthritis makes the condition even more likely. How it develops Although the exact cause of trigger finger is unknown, the progression of the condition is well documented. Trigger finger involves the tendons and pulleys in the hand that bend the finger. The tendons connect the muscles of the forearm with the bones of the fingers. Each tendon is covered by a slick lining or sheath. When you bend your fingers, the tendons glide back and forth, guided by a restraining pulley or yoke. When the tendon sheath becomes inflamed, it swells and may develop a knot or thickening in the tendon. The knot passes through the pulley as the finger bends, but gets stuck as the finger straightens. This causes further irritation and results in a vicious circle of irritation, swelling, catching and more irritation until finally, the finger locks in a bent position. Diagnosis No X-rays are needed to diagnose trigger finger. Your doctor will examine your hand and fingers, and use the findings to make the diagnosis. The finger may be swollen and there may be a bump, or nodule, over the joint in the palm of the hand. The finger may be stiff and painful. Although it may seem that the problem is in the knuckles, it is actually around the joint nearest the palm of the hand. Treatment Treatment aims to reduce swelling and eliminate catching. Initial treatment is usually conservative, involving rest and taking aspirin or ibuprofen to reduce swelling and ease pain. If symptoms persist, your physician may administer a steroid injection in the tendon sheath. Although there may be some short-term discomfort from the injection, it can relieve the pain and locking for several months. Injection is more effective usually than oral medication, Surgery is recommened if the injection is not effective or helps only briefly. Injections can not be repeated too often. Generally no more three injections are recommened. The surgery is done on an outpatient basis and can restore active motion immediately. The surgery involves the release of the pulley (band) where the nodule catches. Recovery generally occurs within six weeks. However, hand therapy may occasionally be needed to regain better use of the finger(s).
The information presented has been modified from the American Academy of Orthopaedic Surgeons. |
