Trigger Finger is becoming
a common, yet quite serious problem among many individuals,
just as Carpal Tunnel Syndrome has been the past
decade, and still is. Although Carpal Tunnel has
received all the media hype in the past, Trigger
Finger is currently affecting millions of Americans
each year, causing suffers to experience lost time
from work, expensive rehabilitation and often long-term
disability, resulting in millions of man-hours and
billions of dollars lost to the business, government
and healthcare sectors.
So the question arises; what is Trigger Finger and
how can it be eliminated without taking medications
that may not be necessary, undergoing painful cortisone
injections or even worse, being subjected to surgery,
which has very poor results? The past few years have
seen physicians prescribing ever-increasing numbers
of invasive treatment methods that are often not the
solution to treating either disease or injury, and
completely avoiding the application of sound conservative
The reason is simply money. Don’t
be surprised as this is what the healthcare industry
is inundated with. So, it is up to the patient
to either find a physician that will implement conservative
therapy first and try invasive treatments if all other
measures fail, or address their injury themselves via
conservative therapeutic alternatives. So let’s
learn about Trigger finger and what can be done to
help address this serious injury.
What are the Telltale Signs and Symptoms of Trigger Finger?
Trigger Finger can effect any and all fingers
as well as any of the MP, PIP and DIP joints of the
fingers although it usually comes in a couple of
basic forms: The first is where the distal joint of the finger is bowed
into a flexed position. This form of tenosynovitis does not cause the
finger to lock into the palm of the hand, and although it can be manually straightened
with force, it goes right back to the bowed position.
The second type
of Trigger Finger is the most common, and that is
the locking of a finger or fingers into the palm
of the hand. The affected finger can be flexed downward
but as the finger is straightened, it either stays in the locked-down position
or quickly snaps and jerks back into the extended position. This snapping
or jerking can be painless or painful, depending upon the severity of the condition. If
the finger locks in the flexed position and cannot extend on its own, it can
be extended with force, generally using the opposing hand.
What is Trigger Finger and Why Do I have it?
The finger’s flexor tendons are secured in place
by a series of ligaments called "pulleys".
These “pulleys” form a tunnel so that when
the flexor muscles are contracted, the tendons can
move along the bone in a straight line. In order to
make sure these tendons travel in a smooth manner,
the body produces and coats the flexor tendons with
synovial fluid, allowing the tendons to glide through
the tunnel without difficulty. The problem occurs when
a flexor tendon becomes damaged via direct trauma or
repetitive stress, creating micro-tears in the tendon
that result in swelling and accumulation of scar tissue
as it heals.
When the damaged area is continually stressed, it
keeps accumulating scar tissue to repair itself,
creating a nodule or fibrotic adhesion. As this area continues
to generate scar tissue, it becomes larger, causing
increased friction as it attempts to pass through the
pulley system each time the fingers are moved. Even
if the area of injury on the tendon has completely
healed, but has a nodule / adhesion on it, each time
the finger is flexed and extended, it is re-irritated
and the swelling increases causing the nodule / adhesion
to enlarge and lock the finger into the palm of the
hand. The reason the nodule / adhesion will pass through
the pulley system as the finger is flexed but not when
it is extended is that the nodule / adhesion is smaller
on the front and larger on the back. This causes
it to move through the pulley, but become stuck as
the finger is brought back to a straight position.
NOTE: Trigger Finger can also
be caused by the following medical conditions:
Rheumatoid Arthritis, gout and partial tendon lacerations.
Trigger Finger may also be caused by an infection
of the synovium, resulting in the scarring and
formation of a nodule on the tendon. Trigger Finger
can also be caused by a congenital defect that
forms a nodule inside of the tendon.
Treating Trigger Finger Injuries:
Trigger finger can sometimes be treated with rest,
activity modification and oral anti-inflammatory medications,
or in more extreme instances, invasive procedures such
as steroid injections and surgery are utilized. The
most optimal measure in cases where the disorder is
caused by direct trauma or repetitive overuse is the
use of conservative therapy utilizing stretches and
exercises to address the actual cause of the disorder,
allowing the tendon sheath to return to its normal,
pain-free condition. By allowing the area to heal,
then initiating stretches and exercises to break down
the nodule / adhesion on the tendon as well as stretch
and thin it, the tendon will glide freely through the
pulley system without causing irritation to the synovial
sheath, thereby eliminating the cyclic irritation,
swelling and scar tissue build-up that occurs.
Steps for Successful Treatment of Trigger Finger:
Author: Jeff P. Anliker, LMT, is a
therapist and inventor of products that prevent and
treat carpal tunnel syndrome, trigger
finger and repetitive strain injuries without surgery
or other invasive methods.
Reduce Inflammation - Be sure that
the acute phase of injury is over and no visible swelling
Stretch - Use passive and active stretches on the affected
finger to help lengthen and thin the affected tendon.
Implement Flextend / Restore exercises - Perform simultaneous
strengthening and stretching exercises.