Has one of your fingers ever become stuck in a bent position, becoming painful and difficult to straighten after holding your cup of coffee? Or, does your finger click when you are holding a knife and fork? Maybe you’re even waking up with numb hands alongside these symptoms. If so, then you may be experiencing trigger finger. Read on to learn more about this condition as well as how to treat trigger finger without surgery and tips for managing the symptoms effectively.
What is Stenosing Tenosynovitis, or Trigger Finger?
Stenosing tenosynovitis, commonly known as trigger finger, is a condition where the lining of the flexor tendon becomes thick or swollen. The increased thickness and swelling compress the affected tendon preventing it from gliding smoothly. This can cause the tendon to click or get stuck and locked. Prolonged irritation through repetitive use of the hand may cause scarring and the formation of nodules. The average age of onset is 50 or older, and evidence suggests the ring finger is most commonly affected, followed by the thumb, but all fingers can be affected.
Let’s review the basic anatomy of trigger finger. Each finger has tendons that run on the palm side of the finger that is responsible for flexing or bending the finger. These tendons are surrounded by a protective sheath and run through a system of pulleys that help to keep the tendon in place. In most cases, the most common location for developing trigger finger is at the base of the finger on the palm side of the hand at the large knuckle called the metacarpophalangeal joint (MCP). This is the area of the A1 pulley. You can think of the A1 pulley as the eye of a sewing needle and the flexor tendon in its sheath is a piece of thread. When the tendon sheath becomes swollen and irritated, it would be like trying to thread twine through a sewing needle; it would become stuck.
Signs and Symptoms
Trigger finger symptoms can look like:
- Stiffness in your finger
- Tenderness and/or a nodule at the base of the finger
- Locking of your finger in a bent position
- Popping or clicking when you move your finger
Causes and Risk Factors
The exact cause of trigger finger is not known. There are several factors that could contribute to trigger finger, including:
- Repetitive use of the hand
- Prolonged use of hand-held tools
- Local trauma to the hand/finger
- Degenerative forces and stress to the hand
How do you release a trigger finger at home?
Trigger finger surgery is not always necessary and treatment options can include trigger finger release at home. If you find your finger locks or “gets stuck” at home, a trigger finger can be released at home in a few, simple steps. First, place your fingers or entire hand in warm water for approximately 5-10 minutes. This will allow the tissues to relax and promote increased hand and finger movement.
A heating pad could also be used. Once the hand is warmed up, gently try to make a fist and then straighten the fingers. Repeat this several times until the finger loosens. You may need to apply gentle pressure to the affected finger to assist in straightening the finger out.
Another technique to release a trigger finger is to locate the nodule in the palm in the area of the affected finger. Gently massage the area using a circular motion to gently release the tissues and attempt to straighten your fingers.
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Can trigger finger be treated with therapy?
Yes, another option for treating trigger finger without surgical treatment is rehabilation physical therapy There are several options when it comes to treating trigger fingers, including conservative treatment options or non-surgical management. An occupational therapist or hand therapist can guide you through the process of decreasing your trigger finger symptoms and improving how your hand works. Symptoms can be treated with:
- Heating treatments: Heating treatments, such as a moist heating pad or paraffin wax can be applied to your hand to alleviate stiffness and prepare your hand for therapy. Your therapist will use various manual therapy techniques including stretching your fingers to improve your range of motion, and soft tissue massage to decrease stiffness and increase circulation to the area for healing.
- Manual therapy techniques: Another treatment option for treatment is using a small finger splint that can be made by your therapist. These small splints limit the affected finger from flexing or bending repetitively at the MCP joint or the large knuckle of the finger. By allowing the inflamed tendon to rest, the inflammation will decrease, and the triggering or locking of the finger should lessen. The finger splint is typically worn during times of activity during the day and can be used at nighttime as well.
- Finger splints: In addition to techniques provided in therapy, your therapist will provide you with an exercise program to complete at home to maximize your range of motion and function of the hand.
What happens if trigger finger goes untreated?
Trigger finger and trigger thumb symptoms need to be addressed to maximize hand function and decrease pain. Inflammation, stiffness, and pain typically get worse when you leave an untreated trigger finger alone, and you may find the affected finger is locking more frequently. This can impact your hand function and your quality of life.
How Long Does It Take to Recover from Trigger Finger Without Surgery?
Recovery time for trigger finger without surgery varies depending on the severity of the condition and how early treatment begins. With consistent therapy, most people experience improvement in symptoms within a few weeks to a couple of months. The use of splints, stretches, and heat therapy, combined with modifications to daily activities, can significantly reduce pain and stiffness. However, the time it takes to regain full function may differ based on individual factors such as age, overall health, and adherence to the prescribed home exercise program. Being patient and consistent with your treatment plan is key to achieving a full recovery.
Preventing Trigger Finger Recurrence
Once you’ve recovered from trigger finger, it’s important to take steps to prevent the condition from recurring. Here are a few tips to protect your hands:
- Activity Modification: Avoid repetitive gripping or pinching motions that put stress on the fingers. If your job or hobby involves repetitive hand and finger movement, take frequent breaks and alternate tasks to give your hands a rest.
- Use Proper Tools: If you use tools frequently, ensure they are ergonomically designed to minimize stress on your fingers. Cushioned grips and larger handles can reduce strain.
- Stretch and Strengthen: Regularly stretching your hands and fingers can keep them flexible, and strengthening exercises can help maintain healthy tendons. Your therapist can recommend trigger finger exercises to continue even after recovery.
- Pay Attention to Early Signs: If you begin to notice any stiffness, clicking, or pain in your fingers, don’t ignore it. Early intervention can prevent the return of trigger finger symptoms.
Occupational Therapy Can Help
Trigger finger can have a significant impact on the use of your hand and your daily routine. Recognizing and addressing symptoms early is a key factor in treating trigger finger. Occupational therapy is an excellent avenue for conservative or non-surgical management of trigger finger and can help in the following ways:
- Providing a comprehensive home exercise program to encourage a range of motion and increased hand function.
- Fabricating a splint to promote the rest of the inflamed finger or thumb.
- Providing education on activity modification, including rest, to reduce irritation to the involved finger while maintaining the ability to participate in your daily activities.
- Using heating treatments and manual therapy techniques, including stretching and massage, maximize the function of your hand.
At Ivy Rehab, our occupational therapists and certified hand therapists specialize in the treatment of the trigger finger. Visit our website for location information or to request an appointment online.
Article By: Jessica Abraham, OTR, CHT
Jessica began her Occupational Therapy career 15 years ago. Jessica loves working with the adult and geriatric populations and believes in the importance of providing comprehensive, compassionate care. She currently specializes in hand therapy and became a Certified Hand Therapist in 2014. Jessica enjoys working with clients with orthopedic and neurological upper extremity diagnoses to reach their fullest potential for an independent lifestyle. She currently treats patients at Ivy Rehab/All Care Physical Therapy, Specialty Services Center in Toms River, NJ.
