Stenosing tenosynovitis, also known as trigger finger, is a painful condition involving the thumb or ring finger. If can affect both hands or more fingers or just one. Usually it happens when one is straightening or bending the finger, causing the finger to be locked and snaps straight back.
Anatomy & Cause
The long cord-like structures that the forearm muscles attached to the bones of the fingers are called flexor tendons. It’s purpose is to enable the fingers to bend when the muscles contract. Tendon sheath, is the tunnel between the palm and fingers, where the flexor tendons pass through as the fingers straighten and bend.
The bands of fibrous tissue along the tendon sheath are known as pulleys. The pulleys hold the flexor tendons close to the finger bones. As the finger moves, the tendons pass through the pulleys. The A1 pulley is the pulley at the base of the finger.
When the A1 pulley of the affected finger becomes swollen or inflamed, it is a condition of trigger finger. Trigger finger obstruct the normal gliding motion of the tendon through the sheath and chronic repeated irritation can cause swelling of the flexor tendon itself and forms a nodule. A feeling of popping or locking occurs when the nodule passes through the pulley or flexing of fingers.
We provide diagnosis, treatment and managing Joint Pain related problems.
The factors that may lead to an increased risk of trigger finger include:
- Occupation. More common whose job or interest includes gripping or repetitive hand movements, such as athletes or musicians, industrial workers or technicians
- Gender. Predominate in women than men
- Pre-existing medical conditions such as rheumatoid arthritis and diabetes.
- Age. People between the age of 40-60
X-rays and investigations are not required. Your doctor can diagnose trigger finger through a physical examination of the affected finger and hand and thorough history consultation.
- Tenderness or inflammation in the palm near the bottom of the affected finger
- Sudden snapping back straight with pain of the finger from a bent position
- A clicking sensation or pop, when finger moves
- In extreme cases, the finger may be unable to straighten and persistently bent
- More severe right after waking up in the morning or a period of idleness, rigidity of the fingers
Treatments will depend on the diagnosis of trigger finger:
- Medication. Nonsteroidal anti-inflammatory drugs (NSAIDs) and paracetamol for pain relief can be orally consumed.
- Splinting. Secure a splint at night to keep the finger in a straightened position for up to six weeks.
- Surgery. As a last resort, using local anaesthesia, a procedure called trigger finger release surgery can be undertaken.
- Rest. Use padded gloves or do not engage in the causative activity
- Exercises. Improve maneuverability and alleviating rigidity of the finger through light stretching exercises
Corticosteroid (H&L) injection. An immediate yet short three months relief – Cortiosteroid injections – for the severe shoulder pains.
Dr. Tan & Partners (DTAP Clinic) @Siglap
Dr. Edwin Ong is currently practising in Men’s Health & Sexual Clinic @Siglap
914 East Coast Road
#01-04 The Domain,
+65 6962 2144
Monday, Wednesday & Friday
10.00 a.m to 6.00 p.m.
Tuesday & Thursday
12.00 noon to 8.00 p.m
9.00 a.m. to 2.00 p.m
Sunday & Public Holiday Closed