Stenosing tenosynovitis, or the more common name trigger finger, is the term used to describe a condition where the flexor tendons of the finger on the palm side of the hand catch, click, or lock as they enter the pulley system of the finger.
What causes trigger finger?
Trigger finger is most commonly linked to multiple medical conditions including diabetes, kidney disease, thyroid disease, and a few other medical problems and medications. Other contributing factors may include repetitive trauma, and some people are even born with predisposing factors.
What are the symptoms?
Some of the earliest symptoms of trigger finger are a vague discomfort in the finger associated with swelling, stiffness and pain. There may or may not be tenderness in the palm right where the tendon enters the pulley system of the finger which roughly corresponds to the crease in the hand closest to wear the finger starts.
As the swelling in the tendon and sheath increase, painful catching or clicking may accompany the swelling. This happens because the tendon is becoming too swollen to fit into the tight pulley system. It is similar to a piece of thread being pulled through the eye of a needle. If the thread is bigger than the eye of the needle then it will bunch up. In the most severe cases, the finger may become locked in flexion or extension. This represents the usual progression of the disease, but everyone’s experience is a bit different.
Diagnosis and treatment
Trigger finger can usually be diagnosed in a physical exam, along with your medical history. Once the diagnosis is made, your doctor may discuss one or several treatment options based upon the severity of your symptoms:
- Activity modification
- Nonsteroidal anti-inflammatory treatment
Can it be cured?
In short, yes! Mild to moderate trigger finger can successfully be cured noninvasively. More severe trigger finger may respond to an injection which has a success rate ranging from 40-70%. Surgical treatment is reserved for those cases which are exceptionally severe or have failed other treatment options. Surgical treatment involves careful release of the first tendon pulley. This has a very high success rate, but all surgeries carry risk.
When should I talk to my doctor?
If you have finger or hand pain that is affecting your quality of life and preventing you from the activities you want to be doing, it’s time to talk to your doctor.