Trigger finger or stenosing tenosynovitis occurs when inflammation builds up in the tendons of the finger and causes it to stiffen unnecessarily. (Note: tendons are tough tendons that connect muscles to joints/bones). If the condition is relatively severe, the finger is in a bent position and sometimes makes a rattling sound when forcibly straightened-like a person holding the trigger of a gun, as the disease is called. People whose jobs require repetitive hand gripping have a higher risk of trigger finger, as do people with arthritis and diabetes. Treatment varies depending on the severity and cause, therefore an accurate diagnosis is important.
Step
Part 1 of 3: Caring for Trigger Finger at Home
Step 1. Take a break from repetitive tasks/movements
In most cases, trigger finger is caused by repeated gripping of the hand, or flexing of the thumb or index finger. Farmers, typists, industrial workers or musicians are the groups that are especially susceptible to trigger finger because they are bound to repeat finger and thumb movements constantly. Even smokers can catch the thumb of the trigger from repeatedly turning on the lighter. It's best to stop (or limit) repetitive actions that inflame your fingers and possibly pain and contractures-permanent shortening of muscles/joints that result from straining your fingers for too long-will change on their own.
- Explain the situation to your leader (at work), and they may assign different tasks.
- Most cases of trigger finger tend to occur in people between the ages of 40 and 60.
- Cases of trigger finger are often found in women.
Step 2. Apply ice to your fingers
The use of ice is an effective treatment for all minor musculoskeletal injuries (sprains/sprains), including trigger finger. Cold therapy (cold therapy - ice wrapped in a thin towel or frozen gel pack) should be applied to the inflamed tendon to reduce swelling and pain. Inflamed tendons usually look like small lumps or nodules on the underside of your finger or on the palm of your hand, and are tender to the touch. It's a good idea to apply the ice for about 10-15 minutes every hour, then reduce the frequency as the pain and swelling subside.
Applying ice to your finger/hand with an elastic bandage or support will also help control inflammation, but don't tie it too tightly as complete restriction of blood flow can cause further damage to your finger
Step 3. Take over-the-counter NSAIDs without a doctor's prescription
Non-steroidal anti-inflammatories drugs (NSAIDs) such as ibuprofen, naproxen or aspirin can be a short-term solution to help you deal with any pain and inflammation in your finger. The usual dose for adults is 200-400 mg, taken every 4-6 hours. Be aware that treatment with NSAIDs is relatively harsh on your stomach, kidneys and liver so it is best not to use it for more than 2 weeks. Excessive use of NSAIDs (overdose) can cause ulcers or inflammation of the stomach (such as ulcers).
Typical signs and symptoms of trigger finger include: stiffness (especially in the morning), a clicking feeling when moving the finger, the appearance of a tender lump/nodule on the underside of the affected finger, and difficulty straightening the finger
Step 4. Try to stretch the shortened tendon
Stretching the finger affected by trigger finger symptoms may bring back the condition, especially if you catch it in the early stages. Place the palm of your affected trigger finger on the table and slowly stretch your wrist by placing more weight on the table-hold for 30 seconds and repeat 3-5 times daily. Alternatively, gently stretch the affected finger while applying light pressure and massaging the inflamed lump (if you see one).
- Soaking your hand in warm English salt for 10-15 minutes before stretching it may help reduce tension and relieve pain in the affected tendon.
- Trigger finger usually attacks the thumb, middle finger and little finger.
- More than one finger can be affected at the same time and sometimes both hands are affected.
- A hand massage by a physiotherapist is probably best.
Part 2 of 3: Getting Medical Treatment for Trigger Finger
Step 1. Use a suitable finger splint/splint
Your doctor may want you to wear a finger splint at night to keep the sore finger in a stretched position while you sleep, which will help loosen it. (Note: a splint is a kind of small board to bandage a broken bone). A splint may be required for about 6 weeks. Placing a splint also helps prevent your fingers from curling into your fist while you sleep, which can make trigger finger worse.
- During the day, periodically remove the splint to spread your finger out and give it a light massage.
- Alternatively, you can purchase a finger splint made of aluminum. You can buy it at the pharmacy and attach it to your finger using a waterproof tape/bandage.
Step 2. Get a corticosteroid injection (corticosteroid injection). Injections of steroid medication near or into the tendon sheath can quickly reduce inflammation or bring it back to normal, not restricting the movement of your finger. Corticosteroid injections are considered to be the first-line treatment option for trigger finger. Two injections are usually required (within 3-4 weeks apart) and they are up to 90% effective in patients with trigger finger. Some of the most widely used types of corticosteroids are prednisolone (prednisolone or better known as steroids), dexamethasone, and triamcinolone.
- Some of the potential complications due to corticosteroid injections are infection, bleeding, weakening of the tendons, localized cessation of muscle growth and nerve irritation/damage.
- If corticosteroid injections fail to provide adequate resolution then surgery should be a further consideration.
Step 3. Get surgery for the finger affected by the trigger finger
The main indication for the need for trigger finger surgery is if the finger does not respond to any home remedies, splints and/or steroid injections, or if the finger is completely bent and locked and impossible to reduce. There are two types of surgery: open surgery to free the trigger finger and percutaneous surgery to free the trigger finger. Open surgery will involve making a small incision near the base of the affected finger and cutting open the contracted portion of the tendon sheath. While percutaneous surgery is done by inserting a needle into the tissue around the affected tendon and moving it around to stop the narrowing.
- Finger surgery is usually performed on an outpatient basis using local anesthesia.
- Complications that may occur from surgery include local infection, allergic reaction to anesthesia (anaesthesia), nerve damage and swelling/pain that is chronic (continuous).
- The chance of recurrence is only about three percent, but surgery may be less successful for people with diabetes (diabetes).
Part 3 of 3: Diagnosing Complications and Distinguishing Other Conditions
Step 1. Treat the primary infection or allergic reaction
Sometimes local infection/inflammation can mimic trigger finger or the actual cause of tendon contraction/narrowing. If the joints or muscles in your fingers become red, warm and significantly inflamed after a few hours or days have passed then seek immediate medical attention as these signs may indicate an infection or an allergic reaction to an insect bite. Treatment includes incisions and drainage of fluids, soaking in warm salt water and sometimes oral (eaten) antibiotics.
- Bacterial is the most common hand infection and usually results from a rough cut, puncture wound or inward growth of the nail.
- Allergic reactions to insect bites are relatively common, especially for insects such as bees, stinging wasps, and spiders.
Step 2. Perform treatment on the sprained joint
Sprained/sprained finger joints sometimes resemble trigger finger because they are also painful and cause the finger to look crooked or bent. Sprained joints are usually the result of continuous trauma, as opposed to repetitive strain, and require immediate medical attention to return the finger joint to its original shape. The following recovery of finger sprains is largely the same as that of trigger finger in that it relates to rest, anti-inflammatories, ice and splinting.
- An X-ray of the hand can identify a dislocation or crack in the finger.
- Health professionals who can treat finger sprains, in addition to your family doctor, are osteopaths (osteopaths – practitioners of holistic osteopathy), chiropractors (practitioners of chiropractic medicine) and physiotherapists (physiotherapists – people who perform physiotherapy services).
Step 3. Fight arthritis
Sometimes the cause of shortening and inflammation of the finger tendons is related to sudden attacks of rheumatic disease (rheumatoid arthritis) or gout (gout). Rheumatic disease is an autoimmune condition (a condition in which the immune system attacks its own tissues/cells) that attacks the joints aggressively. The condition demands the use of powerful and suppressive anti-inflammatory drugs against the immune system. While gout is an inflammatory condition caused by the deposition of uric acid crystals in the joints (usually the feet, but can also be in the hands), which can affect tendon connections and trigger contractures.
- Rheumatic diseases usually affect the hands/wrist and over time can actually damage the joints.
- Your doctor may ask you to do a blood test to check for signs of rheumatic disease.
- To reduce the risk of gout, reduce the consumption of foods with high purine content, such as meat parts, seafood and beer.
Tips
Follow your doctor's instructions as necessary and also adhere to therapy
Warning
- Consuming cherries and reducing the consumption of vitamin C is a natural way to fight gout attacks.
- Recovery time from trigger finger surgery depends on the severity of the condition and the surgical technique used, but 2 weeks is probably a relatively good guideline.
- If the baby gets a trigger thumb attack, surgery should be done because the possibility can develop into a permanent crook / deformity as the baby gets older.
