Trigger finger , the more common name for stenosing tenosynovitis, is a rather annoying hand condition in which a finger “locks” in a flexed position and becomes very difficult to bend or straighten.
This condition usually occurs when the pulley thickens at the base of the finger thereby narrowing the canal thorough which the flexor tendons glide. The resistance to gliding causes pain as well as a feeling of popping or catching. The repetitive catching of the tendon causes irritation of the flexor tendons and swelling of the pulley.
Etiology
The cause of trigger finger is often unclear. The condition is sometimes associated with rheumatoid arthritis, gout or diabetes. Often, the first sign is discomfort or tenderness in the region opposite the knuckle at the base of the digit. Later, a nodule may form in this area.
Diagnosis
Diagnosis in rather straight forward without the need for elaborate test. It is based on a simple physical examination of the fingers. The patient will open and close the hand while checking for pain and observing for unrestricted motion.
Treatment
Treatment focuses on alleviating the triggering and achieving painful and unrestricted range of motion. A decrease in swelling will facilitate gliding of the tendons. Oral anti-inflammatory drugs, splintage and/or modifying activities that exacerbate the condition provide conservative measures. In other cases, steroid injection in the region of the pulley may decrease the swelling and alleviate symptoms. As a last resort, surgery is performed in which the A1 pulley in the finger, opposite the knuckle, is released allowing unrestricted motion of the tendons. Relief often occurs immediately after the procedure.
