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Trigger Finger

What is Trigger Finger?

Trigger finger refers to catching of a finger as it bends or straightens.  The affected finger may lock in a bent position but with effort it can be straightened with a painful click.

This occurs because a swelling has developed on one of the tendons which bends the finger.  Instead of gliding up and down smoothly, the swelling on the tendon gets stuck on a structure in the palm called a pulley, causing the finger to snag.  The more frequently this occurs, the more thickened the pulley becomes, making the triggering progressively more painful.

Illustration of tendon and inflammed nodule associated with trigger finger
What Causes Trigger Finger?

Trigger finger is a very common condition, especially in older adults. Some metabolic disorders such as diabetes predispose people to trigger finger.  Overuse can be a contributing factor but for many people there is no apparent cause.

Trigger Finger Treatment

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.

Patient wearing a custom made splint to prevent triggering of a finger

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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