About Trigger Finger
Trigger finger is also known as stenosing tenosynovitis. It occurs due to irritation of the A1 pulley of the finger which lies across the metacarpal phalangeal (MCP) joint. When trying to bend your finger, you may experience a catching or locking across the MCP joint. When the finger is stuck in this bent position it is called a “trigger finger”. The finger may be difficult to straighten and sometimes you may forcefully have to extend and “untrigger” your finger. The cause of trigger finger is thought to be due to a narrowing of the sheath that surrounds the tendon in the affected finger. Tendons are fibrous cords that attach muscle to bone. Each tendon is surrounded by a protective sheath which, in turn, is lined with a covering called tenosynovium. The tenosynovium releases lubricating fluid that allows the tendon to glide smoothly within its protective sheath as you bend and straighten your finger like a cord through a lubricated pipe. If the tenosynovium becomes inflamed, the space within the tendon sheath can become narrow and constricting. Due to this narrowing, the tendon can no longer glide smoothly through the sheath and at times may catch, and lock in the finger in a bent position before popping straight. With each catch, the tendon itself becomes more irritated and inflamed, worsening the problem. With prolonged inflammation, scarring, thickening (fibrosis) and bumps (nodules) can form.
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Symptoms of Trigger Finger
The main symptom of trigger finger is locking of the finger when it is bent. Sometimes patients endorse some localized sharp pain when flexing or extending the finger as well. Symptoms may progress from mild to severe and may include the following:
- A popping or clicking sensation as you move your finger
- Tenderness or a bump (nodule) at the base of the affected finger
- Finger catching or locking in a bent position, which suddenly pops straight
- Finger locked in a bent position, which you are unable to straighten
Trigger finger tends to occur more commonly in the dominant hand and most often affects your thumb or your middle or ring finger. More than one finger may be affected at a time, and both hands might be involved. Triggering is usually more pronounced in the morning, while firmly grasping an object or when straightening your finger.
Treatments for Trigger Finger
Treatment for trigger finger usually involves an ultrasound guided steroid or cortisone injection around the inflamed tendon sheath. The A1 pulley and the actual triggering can be visualized under ultrasound as it happens. This area can then be targeted for an ultrasound-guided cortisone injection which decreases inflammation around the tendon sheath and tenosynovium allowing the tendon to once again glide without catching. For those patients who suffer chronic trigger finger, there may actually be adhesions and fibrous thickening that needs to be separated. Our physicians are able to use ultrasound and gently break apart these adhesions without the need for surgery.
If you have symptoms of trigger finger and would like to be treated, contact Ospina Medical. Our providers are experts in ultrasound guided procedures and will be able to improve your pain and restore your function safely and effectively. Contact us today to schedule your consultation at our Midtown Manhattan location.