What Is Trigger Finger?
In trigger finger (flexor digital tenosynovitis), a finger becomes locked in a bent position. The finger locks when one of the tendons that flex the finger becomes inflamed and swollen. Normally, the tendon moves smoothly in and out of its surrounding sheath as the finger straightens and bends. In trigger finger, the inflamed tendon can move out of the sheath as the finger bends. However, when the tendon is very swollen, it cannot easily move back in as the finger straightens, and therefore the finger locks.
Trigger finger can result from repetitive use of the hands (as may occur from using heavy gardening shears) or from inflammation (as occurs in rheumatoid arthritis). To straighten the finger, a person must force the swollen area into the sheath—causing a popping sensation similar to that felt when pulling a trigger. Splinting, moist heat, and nonsteroidal anti-inflammatory drugs (NSAIDs) can help in mild cases. Sometimes a corticosteroid and a local anesthetic are injected into the tendon sheath. Surgery is commonly needed to treat chronic trigger finger.
An injection of a corticosteroid suspension into the nodule may help decrease the tenderness in the area but does not delay progression of the disorder. Surgery is usually needed when the hand cannot be placed flat on a table or when the fingers curl so much that hand function is limited. Surgery to remove the diseased fascia is difficult, because the fascia surrounds nerves, blood vessels, and tendons. Dupuytren’s contracture may recur after surgery if removal of the fascia is incomplete. The disorder also may recur spontaneously, especially in people who have developed the disorder at a young age; those who have family members affected by the disorder; and those who have Garrod’s pads, Peyronie’s disease, or nodules on the soles of the feet.