Orthopedics

OSPI offers the top orthopedic surgeons in Gilbert AZ and the East Valley. Drs. Mahoney, Macqueen, Stewart and Clouse offer minimally invasive General, Sports and Joint Replacement expertise.

Physical Therapy

Whether you are pre or post-operative, OSPI’s East Valley physical therapy team works with you on both active and passive treatments. Your will be in the best hands with our licensed physical therapists!

Chiropractic

The Gilbert chiropractors at OSPI offer a plethora of nonoperative pain relief options such as manipulations, laser therapy, physiotherapy and electrical stimulation.

Family Practice

OSPI offers comprehensive family practice services including allergy testing, BHRT, medical weight loss, aesthetics and full check ups.

Medical Weight Loss

Patients routinely experience dramatic, healthy weight loss with the customized programs at OSPI. The programs combine nutrition, exercise and prescription weight loss options.

Performance Training

OSPI’s integrated team of healthcare providers work with both amateur and professional athletes to maximize one’s performance with sport specific programs.

Pain Management

OSPI’s Board Certified, Fellowship Trained pain doctor offers both medication management and interventional procedures with exceptional outcomes!

Trigger Finger

FAQs on Trigger finger

 

Trigger finger or stenosing tenosynovitis is fast becoming a common repetitive strain injury that is no more confined to age or osteoarthritis factors. There has been a surge in the ergonomic disorders in the last decade with much younger people are diagnosed with it. Trigger fingers is now in the league of Carpal Tunnel Syndrome, DeQuervain’s disease, and similar upper extremity cumulative trauma disorders, which account for over 60% of workplace-related illnesses reported every year.

What is trigger finger?

Trigger finger or stenosing tenosynovitis is a condition where a finger gets stuck as if a trigger is being pulled after it has been bent. The unlocking leads to the finger popping back to normalcy resembling a trigger is pulled and released. When it affects the thumb, the condition is called trigger thumb.

The main cause of trigger finger is the narrowing of the space between tendons in the finger due to inflammation. About three in every 100 people are diagnosed with the condition. Though people in their 50s and 60s face the increased risk, it also impacts those in their 30s and 40s.

Trigger finger primarily impacts ring finger, littler finger, or thumb on the right hand. It may occur in more than one finger at a time. Once stenosing tenosynovitis occurs, it becomes difficult to straighten out the locked finger. In many cases, the other hand is used to unlock the affected finger. Unlocking accompanies a click sensation, mild pain, and swelling.

What are the symptoms of trigger finger?

  • Locking of the finger in “trigger” position
  • Inability to straighten the finger easily
  • Finger stiffness
  • Popping or clicking sound when unlocking
  • Swelling or bump at the base of the affected finger
  • Worsening finger stiffness in the morning
  • Mild pain while straightening the finger
  • Restricted ability to flex your finger

How does it occur?

Trigger finger is traced to the thickening of the sheath and through which flexor tendons move at the base of a finger. Flexor tendons connect bones in a finger with forearm muscles responsible for its movement. They pull and push bones as the muscles contract or expand.

These flexor tendons slide through a small tunnel created by sheaths around them. It provides cover to them, keep tendons in proper position, and allow to them slide causing finger movements. The thickening of the sheath squeezes the tunnel causing tendon to become stuck and this leads to locking of fingers.

Another reason of trigger finger is thickening of flexor tendons. Inflammation or swelling of the lining leads to formation of nodules on tendons. This also causes sticking of tendons in the tunnel.

What are the causes of trigger finger?

  • Thickening of sheath around flexor tendons of fingers
  • Scarring or inflammation in the sheath due to repetitive trauma
  • Thickening of finger flexor tendons
  • Formation of nodules on finger flexor tendons
  • Conditions, such as diabetes, rheumatoid arthritis, gout, carpal tunnel syndrome

Who are at the risk of trigger finger?

Farmers, musicians, factory workers, and those involved in repetitive gripping following their job requirements are at the increased risk of being diagnosed with trigger finger. The condition is also found to be common in those suffering from diabetes or smoking. Consult your doctor, as soon as you feel stiffness or catching sensation in a bent finger.

How is trigger finger diagnosed?

There is no need of elaborating testing or x-ray to diagnose trigger finger. A physical exam followed by an analysis of medical history ensures a perfect diagnosis. The fingers and palm are examined for inflammation, pain, lumps, smoothness of tissues, ability to perform movements, and locking symptoms.

What are the treatment methods available for trigger finger?

  • Rest and Self-Care: Mild symptoms and early-stage trigger finger may be overcome with rest and self-care. Avoid activities involving frequent gripping or causing vibration to your fingers or palm. Massage your palm to detect and prevent any lump formation or tissue thickening.
  • Medication: Anti-inflammatory medicines help reduce swelling, inflammation, and pain associated with trigger finger syndrome.
  • Home Therapies: Regular icing of the area a few times every day, use warm-water soaks every morning, and do gentle stretching exercises.
  • Adaptive Devices: Wearing splints keep the finger in an unstressed position, a key requirement to end inflammation in flexor tendons. It also prevents finger curling when you are sleeping so that you do not face any trigger finger symptoms in the morning.
  • Therapy Treatment: Physical and occupational therapies, such as gentle workouts, acupuncture, acupressure, massage therapy, and pulsed ultrasound, promote microcirculation, myofascial release, and consequent healing.
  • Steroid Injections: Corticosteroid alone or in combination with a local anesthetic offer provides long-term relief from trigger finger symptoms. Injected directly into the tendon sheath, these injections have a high success rate in treating the disorder (up to 90%).
  • Percutaneous Release: The procedure involves breaking apart the constriction using a needle inserted into the flexor tendon sheath. Carried on under fluoroscopic guidance, it opens up the sheath so that tendons have smooth movements.
  • Surgery: Surgical treatment focuses on open incision by bifurcating the sheath above tendons so that tendons are freed from being squeezed with increased place to glide.

References

American Academy of Orthopedic Surgeons

American Society for Surgery of the Hand

Sato SS et al. (2012). “Treatment of trigger finger: randomized clinical trial comparing the methods of corticosteroid injection, percutaneous release and open surgery”. Rheumatology 51 (1): 93–99

Kasdan ML, Leis VM, Lewis K, Kasdan AS (November 1996). “Trigger finger: not always work related”. J Ky Med Assoc 94 (11): 498–9.

Bamroongshawgasame T. A comparison of open and percutaneous pulley release in trigger digits. J Med Assoc Thai. Feb 2010;93(2):199-204

Marks MR, Gunther SF. Efficacy of cortisone injection in treatment of trigger fingers and thumbs. J Hand Surg [Am]. Jul 1989;14(4):722-7

King, Bradley A.; Stern, Peter J.; Kiefhaber, Thomas R. (2013). “The incidence of trigger finger or de Quervain’s tendinitis after carpal tunnel release”. Journal of Hand Surgery (European Volume) 38 (1): 82–3.

Baumgarten KM, Gerlach D, Boyer MI (December 2007). “Corticosteroid injection in diabetic patients with trigger finger. A prospective, randomized, controlled double-blinded study”. Journal of Bone and Joint Surgery (American) 89 (12): 2604–2611.

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