What is the trigger finger and how to treat

The trigger finger, also known as the triggered finger or stenosing tenosynovitis, is an inflammation of the tendon responsible for bending the finger, which causes the affected finger to always be bent, even when trying to open it, causing severe pain in the hand.

In addition, chronic tendon inflammation can also cause the formation of a lump at the base of the finger, which is responsible for a click, similar to a trigger, during the closing and opening of the finger, as shown in the image.

The trigger finger is curable most of the time with the use of physical therapy exercises, but, in the most severe cases, surgery may be necessary.

Main symptoms

Symptoms of the trigger finger may include:

  • Pain at the base of the fingers or the palm of the hand;
  • Swelling of the finger;
  • Finger hardening;
  • Bent finger that, when trying to stretch, produces a painful click like a trigger.

Generally, these symptoms are more intense in the morning, due to inactivity and increased swelling that can usually happen at night.

The thumb, middle finger and ring are the fingers most frequently affected, but inflammation can occur on any finger, especially in middle-aged women.

How the treatment is done

In mild cases, the treatment of the trigger finger is done through physiotherapy, using exercises and massages, which serve to strengthen the muscles responsible for stretching the hand and fingers, maintaining mobility and relieving swelling and pain. Here's how to do some of these exercises.

However, other treatment measures include:

  • Rest for 7 to 10 days, avoiding repetitive manual activities that require effort;
  • Use a proper splint for a few weeks that keeps your finger straight;
  • Apply hot compresses or local heat with warm water, especially in the morning, to relieve pain;
  • Use ice for 5 to 8 minutes on the spot to relieve swelling during the day;
  • Apply anti-inflammatory ointments with Diclofenac, for example, to reduce inflammation and pain.

In severe cases, in which the pain is very intense and makes physical therapy difficult, the orthopedist can apply an injection of cortisone directly on the nodule. This procedure is simple and quick and aims to relieve symptoms, especially pain. However, it may be necessary to repeat the procedure and it is not advisable to use it often because weakening of the tendon and risk of rupture or infection may occur.

When surgery is needed

Trigger finger surgery is performed when other forms of treatment do not work, with a small cut made in the palm of the hand that allows the doctor to widen or release the initial portion of the tendon sheath.

Generally, this type of surgery is done under general anesthesia in the hospital and, therefore, although it is a simple surgery and with low risk of complications, it may be necessary to stay overnight in the hospital to ensure that the effect of the anesthesia passes completely. After that, the recovery is quite fast, and you can go back to performing light activities with your hand in 1 to 2 weeks, according to the orthopedist's guidance.

Possible causes

The most frequent causes for the emergence of the trigger finger are:

  • Performing repetitive activities with your hands;
  • Uncontrolled diabetes;
  • Rheumatic problems.

However, in most cases the cause is unknown and the diagnosis is made by observing the hand and carrying out additional tests, such as ultrasound or magnetic resonance imaging.

Congenital trigger finger

The trigger finger in a baby can occur due to congenital or traumatic factors and when it is not treated properly, severe deformities can occur due to the immaturity of the child's bones.

The treatment for these cases can be done with physiotherapy, massage and surgery after the child is 1 year old. Some doctors prefer to perform the surgery immediately, while others prefer to try other forms of treatment and only after surgery. However, surgery is mandatory when movement is blocked.