Trigger Finger

By Missy Hymel, LOTR, CHT, CKTP Accelerated Hand Solutions, LLC

Why does my finger hurt in my palm, pop when I try to bend it or get stuck in a bent position?

You may suffer with Trigger Finger or in medical terms, flexor tenosynovitis.  Trigger finger is the inflammation of one or more tendons in the palm of your hand.  Tendons are cord-like structures that attach muscle to bone allowing your fingers to bend and straighten.  The tendon is inside a sheath filled with synovial fluid that allows the tendon to glide more easily.  When a tendon becomes inflamed, it swells the lining of the tendon sheath or even the tendon itself may thicken.  The sheath then pinches the tendon preventing it hindering it from sliding easily in the sheath.  When you try to straighten your finger, the tendon may catch or jump (trigger) as it tries to squeeze back through the sheath.  Sometimes, a nodule can form on the tendon causing a bulgy lump in your palm that is tender and painful when you bend or straighten your finger.

What causes trigger finger? Most often, the cause is unknown. It may occur from repeated use of a tool, such as a drill or wrench and/or repeated gripping of any common object for an extended period. Holding tools with excessive vibration with fingers in a flexed position may be a contributing factor such as holding a pressure washer handle, weed eater or any tool that may irritate and inflame the tendons and synovial fluid.  This condition is also common in people with diabetes, arthritis or any trauma to the hand.

Symptoms of trigger finger. The first sign may be pain or a small bump in the palm of your hand.  As the tendon becomes inflamed, the finger may catch, then lock in a bent position. The affected bent finger may stay curled and then suddenly pop straight, as if releasing the trigger of a gun.  This repeated catching and releasing of the finger continues to irritate the tendon and if it persists for several months, the finger may become stiff and limit your ability to fully make a fist without pain.

What is the treatment?  The first course of action is a full evaluation and accurate diagnosis of your condition. Your physician can tell from examining your finger whether the tendon is inflamed. Treatment will depend on the severity of your condition.  Mild symptoms are often treated by resting the finger and taking a recommended anti-inflammatory or possibly receiving a cortisone injection. 

Nonsurgical treatment may include a referral to a certified hand therapist (CHT).  A CHT will perform a thorough evaluation and determine if you need a splint – either a custom fabricated splint or an over the counter neoprene splint which will allow the inflamed tendon to rest.  The CHT may also provide conservative treatment using heat to decrease the pain and stiffness of your finger followed by massaging to decrease swelling.  Treatment may also include ultrasounds to the inflamed tendon to reduce the swelling in your palm along with a series of tendon gliding exercises to help the tendon slide easier through the sheath. Your hand therapist will also discuss ways to modify activities while your finger is healing.

If all conservative measures fail, your physician may recommend surgery to release the sheath around the tendon, enlarge the space and allow the it to move freely.  This surgery can be performed in an outpatient facility. 

If the tendon is mildly inflamed, conservative treatment with a certified hand therapist is very successful.  The ultimate goal of therapy is to relieve your pain, swelling, and stiffness so you can return to your normal, daily activities without any discomfort. 

Should you have any questions regarding your hands and would like to meet with one of our 4 hand therapists for a brief screening of your condition, please contact our office at 985-951-2457 to schedule a free wellness appointment to discuss your options.

Missy Hymel, LOTR, CHT, Owner
Accelerated Hand Solutions, LLC
7047 Highway 190 East Service Rd
Covington, LA 70433
Phone:  985-951-2457
Website: https://acceleratedhandsolutions.com/

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