Trigger finger
Trigger finger, also known as stenosing tenovaginitis, is a common condition. It usually affects middle-aged patients, especially manual workers required to frequently flex and extend their fingers. These repeated finger movements cause wear and tear to the finger tendons and result in inflammation, which eventually leads to tendonitis (tendon swelling and thickening).
The swollen or thickened tendon can become trapped at the entrance to the tendon sheath -the fibrous tunnel that holds the finger tendon in position - and produces the triggering effect when the finger tendon is forcefully moved through the tunnel then releases.
Any finger can be affected, but the thumb and fourth fingers are most affected. You may notice that the finger clicks as it is bent, then when the hand is extended, the affected finger remains bent until it suddenly straightens with a snap. Sometimes, a lump (nodule) will be formed, and it can be felt along the tendon.
As the condition worsens, the affected finger may be trapped in the palm of the hand and can only be manually extended with the other hand. In the worst scenario, the flexed finger is completely trapped and cannot be manually released.
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How will it get better?
Trigger finger treatment options range from doing nothing other than rest, all the way up to surgical options in severe cases. Repetitive finger movements should be avoided to give the inflamed tendon time to rest. A splint can be applied to keep the affected finger extended.
You can also try gentle stretching exercises to improve the condition, or your doctor may refer you to a physiotherapist for some specific advice.
In certain circumstances, shock wave therapy or steroid injections may be considered under specialist guidance. They aim to reduce inflammation to allow free movement of the tendons. Repeat steroid injections are sometimes necessary if the symptoms do not completely resolve after the first injection, but you will be talked through the risks and benefits of this.
Healthwords pharmacists' top tips
A good place to start is some simple pain relief. Ibuprofen is a good option, as it relieves inflammation as well as pain relief.
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When should I see my doctor?
If your symptoms are mild, trigger finger may be resolved simply by adequate rest and gentle stretching. However, if the condition does not improve after a few days or if it starts to affect your daily life, you should speak to your doctor.
After your condition improves, you still need to be careful and avoid any work that can overload your fingers. You may need to use tools to carry out any heavy or repetitive works. Regular stretching exercises can also help to minimise any recurrence.
What will the specialist do?
In severe cases, once all other options have been tried, surgery may be required as a last resort. The fibrous tendon sheath is cut to allow the tendon to move freely again.
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