What is Trigger Finger ?

What is Trigger Finger?

Trigger finger, also known as Stenosing Tenosynovitis, occurs when one of your fingers or thumbs becomes stiff, painful, or locked in a bent position. The condition is caused by inflammation of the tendons that control finger movement (help your fingers bend and straighten) , making it harder for the finger to move smoothly. 

A tendon is a tough, flexible band of tissue that connects your muscles to your bones and helps your muscles move your bones when you contract your muscles. The tendons along the fingers are encased by a protective sheath, and when the sheath becomes inflamed, it can cause the tendon to catch as it moves, creating that snapping or locking sensation.

While it’s mostly common in the middle or ring fingers, any finger can be affected. Trigger finger is also more common in individuals over 40, but it can occur at any age. Certain repetitive movements or overuse of the hand, underlying health conditions (such as Diabetes or Rheumatoid Arthritis), or trauma can increase your risk.

How Does Trigger Finger Occur?

The mechanism of injury in trigger finger involves a few key factors related to the anatomy and movement of the hand:

• Tendon Inflammation: Over time, repetitive hand movements or using them in certain ways, such as gripping, typing, or using tools, can cause the tendons in your fingers to become irritated or inflamed. Over time, this inflammation causes the tendon to become thicker and less able to slide smoothly through its tendon sheath (a protective covering around the tendon).
• Narrowing of the Tendon Sheath: The tendon moves through a small tunnel (called the sheath) at the base of the finger. When the tendon becomes swollen due to inflammation, the tunnel narrows, making it harder for the tendon to glide smoothly.
• Formation of Nodules: In some cases, a small nodule or bump may form on the tendon where it passes through the sheath. This bump can cause the tendon to catch, making the finger feel "stuck" or hard to straighten when moving the finger.
• Snapping or Catching Sensation: As the tendon becomes thicker or develops a nodule, the finger may become "stuck" in a bent position. You might feel a sudden snapping or catching sensation when you try to straighten it.

Who is Most at Risk for Trigger Finger?

Trigger finger can affect anyone, but certain factors can increase the likelihood of developing this condition in certain groups of people:

• Repetitive Hand Movements: People who perform repetitive tasks such as typing, knitting, or using hand tools can put strain on the tendons, and are at a higher risk of developing Trigger Finger.
• Age and Gender: The condition is more common in individuals over 40 years old due to the less flexible tendons. Women are more likely to experience Trigger Finger than men, particularly between the ages of 40 and 60.
• Medical Conditions: People with conditions like Diabetes, Rheumatoid Arthritis, and Gout, as the tendons and sheaths may already be weakened or inflamed, increasing the risk of Trigger Finger.
• Obesity: Excess body weight may contribute to inflammation and stress on the tendons, increasing the likelihood of developing this condition.

Symptoms of Trigger Finger

The symptoms of Trigger Finger can range from mild discomfort to severe pain. Some of the most common signs include:

• Pain and Tenderness at the base of the affected finger (near the palm).
• A catching or snapping sensation when moving the finger.
• Difficulty straightening the finger after it has been bent. In some cases, it can become difficult to fully straighten the finger without manual help.
• Swelling around the finger joint.
• Stiffness, often worse in the morning or after periods of inactivity.
• A visible lump or nodule at the base of the finger, where the tendon is irritated.
• Limited range of motion in the affected finger, making it harder to grip or perform everyday tasks.

In more severe cases, these symptoms can make everyday activities like gripping, typing, or even holding objects difficult and painful. If left untreated, Trigger Finger can cause long-term stiffness or permanent deformity in the finger.

How Physiotherapy Can Help Treat Trigger Finger

While Trigger Finger may sound serious, the good news is that Physiotherapy can be highly effective in treating the condition without the need for invasive procedures like surgery. The goal of Physiotherapy is to reduce inflammation, reduce pain,  improve tendon mobility, and strengthen the muscles around the joint to prevent further episodes of locking.

1. Education and Activity Modification

If the condition is caused by repetitive hand motions (like typing or using tools), a Physiotherapist will help educate you on altering your grip or adjusting how you perform certain actions to reduce strain if you’re engaging in repetitive tasks that stress your fingers.

2. Splinting

A common treatment approach is to use a custom-fitted splint  worn to keep the finger in a neutral position and some time to rest, preventing further strain on the tendon and reducing inflammation. In some cases, your Physiotherapist might recommend wearing a splint overnight or during specific activities that might trigger the symptoms.

3. Pain Relief

Heat and cold treatments can be used to manage pain and inflammation associated with trigger finger. 

Ultrasound Therapy uses soft sound waves to aid with improving circulation and promote healing thereby reducing the inflammation along the tendon sheath.

4. Corticosteroid Injections 

If the symptoms are persistent or severe, corticosteroid injections are used in conjunction with Physiotherapy. Corticosteroids (often called steroids) are powerful anti-inflammatory medications that can help reduce the swelling and irritation in the tendon sheath.

The injection is typically administered directly into the affected area, where the tendon and its sheath are inflamed. This helps to reduce swelling, improve the movement of the tendon, and alleviate the pain and discomfort caused by trigger finger. At Relive Physiotherapy, we use Ultrasound Guided Injections, which means that our expert Injection Therapist can get the injection in exactly the right place.

Early intervention can help prevent the condition from worsening and improve the chances of recovery without surgery which is typically a last resort if other treatments don't work.

5. Manual Therapy

Soft Tissue Mobilisation: This technique targets to ease tension in the muscles and tendons around the affected finger to reduce tension and promote better movement.

Joint Mobilisations: These gentle movements aim to improve the range of motion and decrease stiffness in the finger joint.

6. Acupuncture: 

Acupuncture involves inserting very fine needles into specific points on the body to stimulate energy flow and promote healing. It helps with pain relief and improved mobility by reducing inflammation and relaxing tight muscles around the affected tendon.

7. Stretching and Strengthening Exercises

One of the primary treatment options in Physiotherapy is a set of specialised exercises designed to improve flexibility and strength in the affected finger. Stretching exercises can help reduce stiffness, restore flexibility and encourage smooth tendon movement, while strengthening exercises aim to reinforce the muscles and tendons and increase support around the joint. Tendon Gliding Exercises and Grip strengthening to strengthen the hand and fingers.

8. Shockwave Therapy (ESWT)

In some cases, when the condition persists, your Physiotherapist may recommend extracorporeal shockwave therapy (ESWT) which involves using high-intensity sound waves to stimulate healing in the tendon by helping breaking down the scar tissue around the tendon and promote tissue regeneration.

How Long Does Recovery Take?

The duration of recovery can vary depending on the severity of your Trigger Finger and how well you respond to treatment. In mild cases, symptoms may improve within a few weeks of Physiotherapy, while more severe cases may take several months. Most individuals begin to notice improvements within 4-6 weeks with consistent treatment.

Preventing Trigger Finger in the Future

Once you’ve recovered from Trigger Finger, your Physiotherapist will help you develop strategies to prevent the condition from returning. These might include:

• Modifying activities that strain your fingers and taking regular breaks
• Incorporating regular hand and finger exercises into your routine to strengthen and maintain flexibility around the affected tendon can reduce the chance of reinjury.
• Using ergonomic tools or equipment to promote a neutral wrist position and reduce stress on the hands and fingers.

Moderation is key. Avoid overdoing activities that place strain on your fingers, gradually increasing the intensity or duration of activities that involve hand use. If possible, switch tasks or use both hands to reduce the repetitive load on just one finger.

If you have conditions like Diabetes, Rheumatoid Arthritis, or Gout, managing those conditions well with the help of a healthcare provider can reduce the risk of reinjury. These conditions can increase inflammation in the body, which may contribute to the development of Trigger Finger or worsen symptoms.

Avoid squeezing objects too tightly. Try to use a lighter grip. When possible, choose tools or objects with handles that fit more comfortably in your hand, reducing the strain on your fingers.

To avoid reinjury of Trigger Finger, it's important to adopt strategies that protect your fingers from further strain and promote long-term recovery. 

Come to Chester’s Best Physiotherapy Clinic for Trigger Finger, and we will be able to discuss your specific case with you, and build a treatment plan that works as you want it to.  Before we set out the treatment plan, we will examine the affected area and give you the different options. We know what we are doing with Trigger Finger and have a range of different treatment options for you!