Trigger Finger or Trigger Thumb is a condition in your hand that causes pain, and sometimes you can feel a “clicking” when making a fist or even when straightening the hand.  The most common finger to get this condition is the ring finger.  But it can occur in any finger or even in your thumb.  

Trigger finger or thumb is also called stenosing tenosynovitis (stuh-NO-sing ten-o-sin-o-VIE-tis).  When inflammation occurs from trauma, the space within the sheath of the tendon enlarges, and thus the tendon no longer slides through the narrow pulley system in the fingers or thumb.  (See the link below for a diagram of the pulley system in our hands.)

Our fingers are stronger when we make a fist than when we straighten our fingers; thus, sometimes we have enough strength to pull that inflamed portion of the tendon through the 1st pulley of the finger.  This pulley is naturally found at the base of each of the fingers on the palm-side of our hand.  If this nodule is large, it may slide when making a fist, but because our fingers are weaker when we are straightening the fingers, we may not be strong enough to pull that enlarged swollen area back through the pulley system. 

So that is why sometimes it takes using your other hand to lift up the finger if it’s stuck in a bent position.  

Symptoms

Signs and symptoms of trigger finger may progress from mild to severe and include:

• Finger stiffness, particularly in the morning
• A popping or clicking sensation as you move your finger
• Tenderness or a bump (nodule) in the palm at the base of the affected finger
• Finger catching or locking in a bent position, which suddenly pops when trying to straighten the finger
• Finger locked in a bent position, which you are unable to straighten

Occurrence

Trigger finger can be found in more than one finger at a time, and both hands might be involved. 

• More common in women than in men.
• Most common between the ages of 40 and 60
• Underlying diabetes
• Underlying hypothyroidism
• Underlying rheumatoid arthritis
• Underlying tuberculosis
• Performing repetitive activities that can strain your hand, such as playing a musical instrument
• Performing sustained gripping tasks such a holding a weed trimmer or a power sprayer.  
• Sometimes noted following a carpal tunnel release

Hand Therapy

Hand Therapy is very instrumental in helping to resolve trigger finger/thumb with conservative treatment if only minimal clicking is noted, and the finger is not locking.  If the finger is “locked,” then surgery may be required.

Conservative Hand Therapy

Patient education is paramount here at Premier Physical Therapy.  We want you to really understand your condition so that you have the tools needed to treat this condition conservatively.  Hand Therapy can include the following. . . 

• Rest: keep the hand from assuming the flexed or bent position.  We can fabricate a day and/or night orthotic, which may be needed to assist with this.
• Transverse friction massage over the area of the A1 pulley to help decrease the inflammation. 
• Gentle range of motion exercises to maintain or improve motion in the finger or thumb joints.  
• Activity modification to avoid further irritation.  
• Instruction in the use of modalities, including heat/ice and possibly provide:
  • Ultrasound
  • Iontophoresis 

No matter what type of hand pain you’re experiencing, it’s important to understand that you CAN feel better. The first step is finding out the CAUSE of the pain. Seeing a hand therapist at Premier Physical Therapy is a great way to understand your hand pain and start your treatment to get better.

It’s time to feel better NOW! Call your doctor NOW to get your script! Then, give us a call TODAY to schedule an appointment at 573-335-7868.

Click on these links for more information on Trigger Finger or Trigger Thumb.https://www.assh.org/handcare/condition/trigger-finger  then click on Trigger Finger: Symptoms and Treatment | The Hand Society

https://www.asht.org/sites/default/files/docs/2018/Trigger%20Finger%202018.pdf   than click on ASHT