Stenosing tenosynovitis, also known as 'trigger finger', is a painful condition that results in pain, stiffness and clicking when you try to straighten a bent finger or thumb. It commonly affects just one digit and is a disorder of the tendon sheath that runs from the palm towards the fingertip.
What is trigger finger?
The action of bending your finger or thumb relies upon the function of tendons, which join the muscles of your forearm to the finger bones to make movement possible. These tendons are held in place by a tunnel of ligament tissue over the surface of the bone, which the tendons slide through; this is known as the tendon sheath.
If there is a problem with the tendon or sheath - for example a swelling, which means the tendon can no longer slide easily through the sheath - it becomes harder to bend and straighten the fingers.In trigger finger, the tendon gets caught in the opening of the sheath, with the finger in a bent position. As you try to straighten it, the finger either locks or 'pops', which is usually painful. You may also notice a small lump of tissue, called a nodule, at the base of the affected digit.
What causes trigger finger?
It is not known exactly what causes trigger finger. What is fairly well established is that the condition can be aggravated by repetitive or strenuous activities, including typing and anything that demands regular tightening of the grip. There are also certain factors that seem to make trigger finger more likely: it is more common in women, the over 40s and in those with certain long-term conditions such as diabetes
Treatment for trigger finger
The good news is that around 1 in 4 people find trigger finger gets better with rest. For the remainder, there are several treatment options. If left untreated, trigger finger can worsen and leave the finger permanently bent.
- Painkillers and non-steroidal anti-inflammatory drugs (NSAIDs) can help reduce swelling; these are most effective when combined with rest. You will need to avoid any activities that involve repetitive bending and straightening, which puts stress on the irritated tendon.
- A splint can be prescribed to support the affected finger, particularly overnight if you find that the pain occurs in the morning.
- Corticosteroid injections, sometimes described as a 'cortisone injection', can be used to try to reduce swelling and see if this alleviates the problem.
- If the above methods have not been successful it is possible to perform surgical treatment to free up the affected tendon. It is a straightforward, minor procedure under local anaesthetic that is usually very effective, but requires up to four weeks' recovery.To discuss your symptoms and agree on the right course of treatment, please get in touch and make an appointment.