Stenosing Tenosynovitis, better recognized as Trigger Finger, is a defect that has gained further insight in the medical industry over the last few years. Often classified as a disease, its relation to repetitive stress and direct trauma has been embraced, revealing it as just another form of repetitive stress disorder like carpal tunnel syndrome or tennis elbow.
The symptoms of Trigger Finger can change in severity, but the recognizable symptomology of the finger snapping is one that cannot be mistaken for anything else. As the finger is flexed downward towards the palm of the hand, the finger can jerk down, locking into the palm of the hand. As the finger is straightened, often times with the assistance of the opposing hand, it will snap back to its correct anatomical position. For some, the finger may be more painful as it snaps downward into the palm, and for others it is just the opposite, with more out of control pain as the tendon snaps backward into the extended position.
The locking of the afflicted finger is the result of an adhesion that has formed on the flexor tendon to become stuck within the pulley system as the finger is bent and extended. Although Trigger Finger may reveal itself due to acute trauma such as falling onto an outstretched hand, causing micro-tears in the flexor tendon and the formation of scar-tissue on the affected tendon, it is most often caused by never-ceasing overuse of the fingers performing finger flexion such as typing, grasping tools, etc. Repetitive motion, plus frequency, duration and force have the same effect as the acute injury caused by blunt trauma, but it occurs over a longer period of time. The end result is little micro-tears that create scar-tissue due to repeated use of the afflicted finger, resulting in increased friction within the tendon sheath and thus causing more swelling and the constant cycle of irritation, inflammation, swelling and nodule growth.
Although direct injury and repetitive use can cause Trigger Finger, there are also other pre-cursors that increase the likelihood of developing this ailment. Swelling caused by Arthritis may irritate the tendon and its sheath and the infection of a finger caused by a laceration can cause irritation and scarring of not only the tendon by also the tendon sheath.
Time and again, physicians suggest rest and over-the-counter medications for correcting Trigger Finger, especially if the symptoms are more lax or if they are just starting. If symptoms are more progressed, they may recommend a brace or a cortisone injection. If cortisone is utilized, the individual needs to be really apprehensive, as the injection may be very painful. They also need to be aware that while the positive effects of cortisone include a reduction of pain and overall symptoms, the adverse effects are that it can cause severe degradation of the tendon, resulting in more problems than Trigger Finger itself. Although many doctors will push to have the person return for more injections, it is best to hold back from repeated use of cortisone. Surgery is another choice often chosen, but with minimal relief as the opening of the tendon sheath frequently increases scarring in the area and more arduous Trigger Finger symptoms.
The best rehabilitative outcome for this condition is to embrace conservative therapy while the cortisone is completing its job. This allows for the subject to initiate corrective stretches and exercises while the finger can move through a normal range of motion without pain. The conservative angle to treating Trigger Finger focuses on stretches and exercises that single out the muscles and tendons in the afflicted area.
The active Flextend/Restore stretches and exercises can help reduce the growth by breaking down the scar-tissue and reducing the size of the tendon, allowing it to slide freely through the pulley system without the jerking and associated pain. Thus, the fulfillment of a conservative therapy program utilizing the appropriate stretches and exercises is the most productive therapy available for eliminating the crippling ailment known as Trigger Finger Syndrome.
Jeff P. Anliker, LMT, is a therapist and inventor of products that are used by professional musicians and athletes around the world to prevent debilitating signs and symptoms associated with Trigger Finger Syndrome, Carpal Tunnel and other Repetitive Strain Injuries.