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Trigger finger: It’s in your hands


After hours of gripping the wheel, do you find it hard to straighten one (or more) of your fingers? If so, you may have developed “trigger finger.” Trigger finger (stenosing tenosynovitis) is a condition in which your finger (or thumb) becomes stuck in a bent position because its tendon can no longer slide freely inside its tendon sheath.

The bones in your fingers and thumbs are attached to your muscles by fibrous cords – tendons – and each tendon is surrounded by a protective sheath. When this sheath becomes inflamed or irritated, it can prevent the tendon from freely gliding inside, stopping the joint from being able to bend.

Prolonged irritation can eventually lead to scarring, thickening, and even a nodule forming on the tendon, which may lock the joint in a flexed position until it eventually straightens and produces a snapping sound similar to a trigger being pulled and released. In extreme cases, trigger finger affects more than one finger (or thumb) on both hands at the same time.

Fortunately, no extensive testing is needed to diagnose trigger finger – just your medical history along with observations while opening and closing your fist, and noted areas of pain, freedom of movement, and obvious locking. Nodules on your palm associated with trigger finger are identified as they move when your affected finger moves.

Trigger finger is most common in these careers: truck drivers, construction workers, manual laborers, assembly line workers, and/or administrative/office/computer positions. This is because each of those professions involves the following activities: repeated gripping, force and posture, force and repetition, vibration, and/or highly repetitive hand movement.

The risk is even higher if you have rheumatoid arthritis, gout, or diabetes; if you are female; or, if you have had carpal tunnel surgery within the past six months.

As trigger finger progresses, signs and symptoms will become more severe. These symptoms include: finger (or thumb) stiffness, especially in the morning; a clicking or popping when you move your finger; tenderness (with or without a bump) in your palm at the base of the affected digit; your finger remaining locked in a bent position, which may suddenly pop straight, or which cannot be straightened without external force.

Since trigger finger is not considered an emergency, just make a regular doctor’s appointment regarding general stiffness, numbness, catching or pain in your finger joint, or if you cannot straighten or bend a finger. However, if your finger joint becomes inflamed and hot, get it checked out right away, since this may indicate a more serious joint infection.

For trigger finger, your doctor may recommend a variety of conservative treatments, depending on severity, duration and lifestyle impact. If pain relief is essential, non-steroidal anti-inflammatory drugs, such as ibuprofen (Advil, Motrin IB) or naproxen (Aleve) are options. However, these medications will probably not improve finger movement.

Rest is also helpful. Until your symptoms improve, try to avoid the activities that caused the condition, like grasping repeatedly, gripping repetitively, and using vibrating handheld machinery. However, when these activities are unavoidable, consider wearing padded gloves to help reduce their impact. At night, you can also rest the tendon by wearing a splint for up to six weeks to keep the affected finger extended.

Gentle stretching exercises may also help retain finger mobility.

If these conservative treatments are ineffective and your symptoms progress, consider more invasive options, such as: steroid injections near the tendon sheath to reduce inflammation and enable unrestricted movement for up to a year; percutaneous release, where a doctor inserts a needle into the tissue around the affected tendon to break away the scar tissue and free the tendon’s movement; or in severe cases, surgery to cut and release the constricted tendon sheath.

To avoid these invasive treatments, feed your body a healthy diet, drink enough fluids to keep tissues lubricated, get enough rest, and consciously retain flexibility by regularly bending and extending your fingers throughout the day. It’s in your hands.

***

Karen Bowen is a professional health and nutrition consultant, and she can be reached at karen_bowen@yahoo.com.


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