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Locking Thumb or Finger?

Updated: Jun 14

Do you have a finger or thumb which is locking in a bent position?

Are you waking in the morning with a stuck finger that is difficult to straighten, or a clicking finger?

If so, you may have trigger finger.

What is Trigger Finger?

Trigger finger refers to catching of a finger as it bends or straightens. The catching or locking is due to one of the finger bending tendons developing a thick nodule on it, which is getting stuck on a structure known as a pulley.

Tendons usually move back and forth underneath the pulleys in your fingers so smoothly that you are not aware of it, but when one of the tendons is swollen it gets stuck on the A1 pulley causing finger locking or catching. The more often this happens, the more inflamed and thickened the pulley becomes, so that the finger may become progressively more painful and difficult to 'unlock'. Trigger finger may affect any of the fingers or even the thumb, in which case it is referred to as trigger thumb.

Trigger Finger Symptoms

As well as a clicking sensation during bending or straightening of a finger, there is often pain in the middle joint (PIP joint) of the affected finger. For this reason, trigger finger is sometimes misdiagnosed as arthritis. Usually there will be tenderness near the top of the palm in line with the affected finger. This is the site of the inflamed pulley where the tendon is catching. Frequently there is also slight swelling.

So Why is it Called Trigger Finger?

Trigger finger apparently got it's name from the 'clicking' or 'popping' sound made when forcing the digit back into a straight position, like a pop or snap of a trigger being pulled and released. The medical name for this condition is stenosing tenosynovitis.... trigger finger is much easier to pronounce!

Trigger Finger Causes

Trigger finger is a very common condition, especially in older adults. Some medical conditions such as diabetes and rheumatoid arthritis can predispose people to trigger finger. Very repetitive gripping, especially of small diameter objects, can also be a contributing factor, but for many people there is no apparent cause.

Trigger Finger Treatment

Splint worn to resolve a trigger finger

Hand therapy treatment consists of fitting a custom-made splint to prevent the finger from triggering and relieve pressure on the inflamed pulley. The splint is usually worn day and night but is easily removed for hand washing, and most daily tasks can be completed with

the splint on.

Treatment with a splint has been shown

to be most successful if the digit has been triggering for less than 4 months. More long-standing trigger fingers may require ultra-sound guided steroid injection in addition to a splint, to help reduce the inflammation of the tendon and the pulley. If the triggering fails to respond to conservative treatment, surgery may be required to release the thickened pulley.

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