Stenosis tenosynovitis, better known as a trigger finger, refers to a condition when finger(s) or the thumb gets stuck in a bent position when attempting to straighten. This is often followed by a “snap” than then eventually the finger or thumb is able to straighten out. This occurs as the result of the tendon sheath becoming inflamed and thickened. The flexor tendon is no longer able to glide smoothly through a small tunnel (tendon sheath).
Symptoms of a trigger finger or thumb include pain, a catching type sensation, popping, and swelling. A small nodule may be present on the palm surface of the hand along the affected finger (or thumb). Commonly, symptoms can be worse first thing in the morning from being inactive all night. As the disease progresses, the ability to straighten out the affected finger or thumb may become more difficult or impossible.
Trigger fingers commonly develop between the ages of 40 and 60 years old and is more common in women than men. The true underlying cause is unknown. There are several known risk factors including diabetes, rheumatoid arthritis, and repetitive finger/thumb movements.
The diagnosis of a trigger finger is made by physical examination. A patient’s history of locking or catching is usually the first clue. As aforementioned, a small nodule may also be felt at the base of the finger or thumb. X-rays may be obtained to rule out any bony abnormalities or arthritic conditions.
Treatment for a trigger finger includes activity modification, non-steroidal anti-inflammatory (NSAID) medications, corticosteroid injections, and splinting of the affected finger(s) or thumb.
A trigger finger release is the surgical option for those who do not respond to non-surgical treatment. This is an outpatient procedure, usually performed under local anesthesia. The tendon sheath is cut to allow for more room within the tunnel that the tendon passes.