Stenosing tenosynovitis, also known as trigger finger, is a common hand condition that affects both men and woman, usually aged 50 or older. The condition is caused by mechanical interference between the finger’s flexor tendon and the sheath that surrounds it. A thickening of the tendon impedes its normal gliding motion and causes it to catch, producing an uncomfortable locking sensation. Over time, this discomfort can become painful around the palm when flexing or extending the fingers. While the catching is sporadic at first, if left untreated, the finger can become stuck in a bent position permanently. The ring finger is affected the most often, followed by the thumb, middle finger, index finger, and lastly the pinky.
Trigger finger can be debilitating and seriously impact your quality of life. It can make everyday tasks and work more difficult, especially at the more advanced stages. If left untreated, trigger finger can result in medical leave, lost income, and lead to the onset of anxiety and depression.
Stenosing tenosynovitis is one of the most widespread hand conditions. An estimated 6% of the North American population is affected. It is mainly seen in adults aged 50 and older and is much more prevalent in women. In rare cases, young children can even be diagnosed with it. In those cases, it is considered congenital and generally affects the thumb.
It’s difficult to pinpoint the exact cause of trigger finger. It affects healthy people of all ages, but there are certain predisposing factors that increase the incidence of the condition. Individuals with underlying medical conditions like diabetes, hyperthyroid, and rheumatoid arthritis are at a higher risk for developing trigger finger. The same is true for people with a history of hand problems, such as carpal tunnel syndrome or Dupuytren’s contracture.
Squeezing or gripping the hand frequently and repeatedly without rest may also trigger or worsen symptoms, but there is little scientific evidence of a connection with manual work. Extended work on a keyboard and with a mouse is not recognized as a cause of trigger finger.
Symptoms are usually mild at first and worsen over time. The condition generally affects the ring finger and thumb and can affect multiple fingers at the same time. When both hands are affected simultaneously, the condition is called bilateral trigger finger.
The symptoms of trigger finger are distinctive and easy to spot.
The condition is diagnosed based on a description of the patient’s symptoms, also known as a clinical history, and a physical exam. Additional exams may be required to assess the severity of the condition and rule out neuropathy.
Ultrasound can be useful to assess the condition of the flexor tendons and the presence of nodules or inflammation. Ultrasound makes it possible to figure out whether dilation of the tendon or a ganglion cyst is causing the condition. During a diagnostic exam, your doctor can also observe how the finger locks when it is flexed or extended. A medical prescription is needed for an ultrasound.
Many different conditions can affect the bones, muscles, joints, or tendons of the hand, or be related to the nervous system. Several of these conditions are interrelated, so individuals with trigger finger are at a higher risk for developing other hand issues like carpal tunnel syndrome, Dupuytren’s contracture, or tendinitis of the wrist.
It can be hard to tell different hand conditions apart. Because many of the symptoms, such as pain, stiffness, and the curving or deformation of the fingers, are similar, certain common conditions are sometimes mistaken for each other, especially early on. This is the case for stenosing tenosynovitis (trigger finger), Dupuytren’s contracture, and osteoarthritis of the hand and fingers.
Here are some of the characteristic symptoms of each of these conditions:
One or more fingers lock in the bent position Needing to use the other hand to manually straighten fingers Painful clicking at advanced stages.
The formation of cords of tissue in the palm of the hand Gradual bending of the fingers Difficulty laying hands flat.
Bone deformities Loss of index–thumb pinch strength Redness and swelling of the distal phalanges (last finger bones).
Hand conditions may occur in isolation, simultaneously, or in succession. Doctors need to be experts in hand anatomy and the supplemental exams that must be performed to diagnose them properly.
What are the signs of trigger finger?
Signs you might have trigger finger include stiffness, pain, nodules, swelling, and the locking of one or more fingers.
What causes trigger finger?
While doctors don’t know exactly what causes trigger finger, age, sex, repetitive manual work, and certain pre-existing conditions are considered risk factors.
Who gets trigger finger?
Men and women of all ages can develop trigger finger, but it is much more prevalent in women, especially those aged 50 and older.
How is trigger finger diagnosed?
A clinical examination and the identification of symptoms are usually enough to confirm a diagnosis. Ultrasound might be used to assess the severity and extent of the condition.
What treatments are available?
Patients can take certain non-surgical steps to ease their symptoms at the early stages of the condition. If symptoms persist or worsen, it means that the condition is advanced enough to warrant surgery.
Everything you need to know to identify and treat trigger finger. Written in clear and simple language by hand surgeon Dr. Jean-Paul Brutus, this e-guide identifies the causes, symptoms, and different ways to treat trigger finger and offers recommendations on how to ease your symptoms at home.