Trigger finger is a disorder characterized by subsequent locking and snapping of the finger flexor tendon (A1 pulley). It is also called trigger thumb or trigger digit. This is associated with pain and dysfunction. People afflicted with the disorder experience difficulty flexing and extending the involved finger. In some cases, the finger stays locked in bent position. The triggering phenomenon happen when the finger unlock, it snaps or pops back suddenly, mimicking the release of trigger on a gun.
This condition if often painful and causes difficulty in performing activities requiring manual dexterity. People who are involved in work or hobbies that require gripping actions are highly susceptible to developing this disease. The disorder can occur in both children and adults. Also, trigger thumb is more common among women and people with diabetes, gout and rheumatoid arthritis.
- Stiff finger locked in bent position
- Painful snapping when flexing and extending the affected finger
- Presence of a tender bump on the side of the palm
- The symptoms are more pronounced in the morning
There is no definitive diagnostic treatment for this disorder. History taking and physical assessment are enough to assert the presence of trigger finger. It usually affects the thumb, index, ring or middle finger. However, there are times when more than one finger is affected. The triggering phenomenon aggravates in the morning or when the person grips an object tightly.
The management of trigger finger varies on the gravity of the condition. For mild cases, the goal of treatment is to minimize the swelling. This is done by wearing a splint at night for a couple of weeks. Taping the affected finger in a straightened position to its neighboring finger also helps with decreasing the swelling. This is more commonly called “buddy tape”. Applying heat and cold compress do wonders in relieving pain in the affected area. And lastly, a bit of stretching may help.
- Pharmacologic – the treatment of trigger finger centers on the pharmacologic measures. One of the most prescribed medications for this disorder is corticosteroid injection. It has been proven effective for more than half of all reported patients. In six months, patients are already free from the triggering symptoms.
- Surgery – when the infection fails, the patient will have to undergo a simple surgery. This can be done on an out-patient setting. The sheath that restricts the tendon, causing the locking and snapping will be cut. This will be done with local anesthesia to control the pain. This is done with the patient wide awake, so for the weak of heart, adequate mental preparation should be done before surgery. The procedure will not take long and will not be that bloody anyway. After surgery, keep the bandage around the incision site for 48 hours. However, this is the more expensive procedure as compared to the steroid injection. This method also poses greater risk for nerve damage.
- Others – taking nonsteroidal anti-inflammatory drugs (NSAIDs) help address pain felt. Adjunct occupational and physical therapy may be done to help the affected finger recover their functions. Others also try alternative traditional measures such as acupuncture.