Trigger Finger

Trigger Finger Stenosing tenosynovitis, commonly referred to as trigger finger, is one of the most common conditions treated at Hand Therapy Experts. It involves inflammation of the tendon(s) responsible for flexion of the finger, leading to pain, stiffness, and a typical “catching” or locking sensation when attempting to bend or straighten the finger. This condition may affect one or several fingers, including the thumb, and can interfere considerably in daily activities involving gripping, writing, or even using a smartphone.

What Causes Trigger Finger?

The problem occurs when the flexor tendons, which are used to help bend the fingers, become irritated and inflamed. The flexor tendons run along the length of the finger through a series of tunnels, or pulleys, to keep the tendons close to the bone as they move. When inflamed, a tendon may thicken and develop nodules, complicating the smooth gliding of the tendon through the pulley. This catching, popping, or locking feeling is usually described in the finger known as the trigger finger.

Common causes and risk factors

Repetitive motion: Activities that require repetitive gripping or motion of the hands and fingers can lead to the development of the trigger finger.
Medical conditions: A variety of conditions, including diabetes and rheumatoid arthritis, put people at greater risk of developing trigger finger due to chronic inflammation.
Age and gender: Trigger finger can present itself in middle age and has been found to be more prevalent in women than men.
Injury: Trauma and/or direct injury to the palm or fingers can set off inflammation of the tendon sheath and result in the condition.

Symptoms of Trigger Finger

Patients with trigger finger may have the following common symptoms:

Pain at the base of the affected finger or thumb, usually worse when gripping or pressing on the area.
Tenderness or a small nodule near the palm where the tendon is thickened.
Catching or locking: as the tendon catches in the thickened sheath, the finger may suddenly lock in a flexed or extended position, and refuse motion until it is coaxed free.
Stiffness: The patients usually complain of morning stiffness leading to the inability to flex their finger above a certain degree.
A popping or snapping sensation when trying to bend or straighten the finger, similar to pulling the trigger, hence the term “trigger finger.”
Severe cases see the finger locking in a flexed position and only able to be extended with manual manipulation. This can also lead to pain and swelling of the joints around it.

Paediatric trigger thumb

This thickening of the flexor tendon can lead to a condition called paediatric trigger thumb, in which the child’s thumb locks in a flexed position. Paediatric trigger thumb is dissimilar to the adult trigger finger because it usually has no recognized contributing factor of repetitive strain; it may be related to variations in the developmental anatomy of the tendon sheath.

Non-Surgical Treatments for Trigger Finger

The Expert Hand Therapy treats the trigger finger with a conservative approach to non-surgical options, emphasising pain and inflammation reduction, acceleration of healing, and regaining full range of motion. Our hand physiotherapist will plan a specific treatment program tailored for the degree of severity of your condition and lifestyle needs. Common modes of treatment include the following.

Finger Splinting: One of the most effective non-surgical treatments for trigger finger includes splinting. A custom-made splint is made to immobilise the involved finger. It limits the finger from bending during activities, which allows the inflamed tendon some time to heal.
Stretching and Finger Exercises: Our hand therapist will take you through specific exercises to gently stretch the tendons and muscles in your hand. These exercises will help to improve your flexibility, reduce stiffness, and encourage normal movement of the tendons.
Hand massage: Soft tissue massage has the potential to reduce the pain and inflammation of the trigger finger. By improving blood flow to the area and releasing tension in the involved tendon, our therapist can help to reduce discomfort and improve movement.
Activity Modification: Repetitive hand activities may irritate the symptoms of the trigger finger. Our hand therapist will collaborate with you to identify and make any necessary alterations in your activity pattern to minimise the effect on your condition. This includes the use of changing grip on tools, using ergonomic equipment, or taking breaks during repetitive activities.
Anti-Inflammatory Treatments: Depending on the severity of the condition, your doctor may prescribe or recommend over-the-counter anti-inflammatory medications to help reduce swelling and pain in the inflamed tendon. Your hand therapist will communicate with your doctor to ensure that you get proper medical treatment in coordination with your physiotherapy program.
Cortisone injection: If symptoms of trigger finger do not improve with finger splinting, a cortisone injection may be suggested as an alternative measure to surgery. Cortisone injections work by lessening the inflammation around the tendon. This reduces pain and allows easier movement of the tendon. If this is a suitable treatment for you, we will send a letter to your GP requesting the injection.

When Is Surgery Recommended?

While non-surgical treatment options may work for many patients, surgery may be required when finger clicking does not improve with finger splinting or cortisone injection. Should your symptoms fail to respond after several weeks of therapy, or the finger remains locked despite the use of above non-invasive interventions, your hand therapist may recommend you seeing a Sydney hand surgeon for a trigger finger release procedure.

It is a surgical procedure that releases the constricting portion of the tendon sheath so that the tendon glides freely again. After surgery, hand physiotherapy is usually indicated to assist in the healing process and to make sure your finger recovers full motion.

Why Choose Hand Therapy Experts?

We pride ourselves on offering person-centred, high-quality care for people with trigger finger. Our hand physiotherapists are specialists in diagnosing and treating conditions of the hand and will provide splinting, non-operative treatments, or post-operative rehabilitation to maximise healing and restoration of function. We work in close collaboration with each patient to develop a personalised treatment plan that may involve finger splinting or other post-surgical rehabilitation.

If you believe you are showing symptoms or have already been diagnosed with trigger finger, please do not hesitate to contact our hand therapy clinic in Sydney for an appointment today.