By using a night splint to keep the finger straight, it can prevent painful locking during sleep. This may increase swelling in the fingers where pain and locking can be more frequent at night and the early morning. When someone lays flat at night, the effect of gravity on the legs is more similar to the arms, so fluid may shift from the legs to the arms. It is estimated that much of the body’s fluid volume pools in the legs during the day when we sit and stand due to the effects of gravity. The ability to restore the finger to what the patient believes is normal or 100% is easier when the problem is diagnosed and treated as soon as possible.Ĭommon treatment options include, but are not limited to: The goal of treatment in a trigger finger is to reduce or eliminate the swelling and catching/locking, allowing full, painless movement of the finger or thumb. Early on, the symptoms may be mildly painful, but as the tendon and pulley interaction becomes tighter, the pain can increase. Sometimes these abnormal sensations occur while bending or straightening the finger, or both. Mechanical symptoms: A trigger finger can cause abnormal sensations or movement that are often described as popping, catching, or locking. ![]() When the joint does not fully straighten for several weeks, a ligament called the volar plate becomes shortened and limits motion. Some patients will feel pain trying to fully straighten. Trigger fingers can also result in loss of the ability to straighten the finger. Over time, the person may start to avoid a bent position of the finger to limit pain. It can be painful to try and bend the finger due to the compression of the fluid. This is most common in chronic, untreated trigger fingers. This can be estimated by how far the tip of the finger is from the palm of the hand when the patient is asked to bend the finger as much as they can. Stiffness or loss of motion: A trigger finger may result in loss of the ability to bend the finger.The cyst is called a flexor sheath ganglion. This can be due to a nodular swelling within the tendon or the development of a fluid filled cyst. Swelling: Over time there may be the development of a lump at the A1 pulley.Over time, if there is increased fluid production in the tendon sheath, this may cause pressure and pain even without hand use. The pain is often only present with activity such as gripping. This pain occurs with pressure over the A1 pulley area. Pain: Trigger finger may start with discomfort felt at the base of the affected finger or thumb, where the finger joins the palm.Some symptoms of trigger finger can include: It is also helpful to know this problem has several very successful treatments. It is rare to require other diagnostic testing. The good news is that trigger finger can be diagnosed by the history, symptoms, and a physical exam. This makes it difficult for the tendon to move back and forth (Figure 2). This thicker pulley causes friction on the moving tendon. The undersurface of the pulley can also change and thicken. ![]() And the higher volume of fluid increases pressure. The bigger lining then produces more fluid. If the tendon becomes tight within the pulley, the lining gets squeezed and reacts with thickening. The change in size of any of the important finger structures can cause problems. The finger tendon and pulley system is designed to have the exact right sizes of each structure. the pulley becomes thicker (the opening for the tendon gets smaller). The lining increases in thickness (does not fit through pulley well) 3. The tendon enlarges (does not fit through pulley well) 2. The pulleys are similar to how a line is held on a fishing rod (Figure 1).Ī trigger finger, sometimes referred to as a trigger thumb or stenosing tenosynovitis, can occur if one of three things happen: 1. The tendon and its lining are designed to glide through the pulleys without friction. ![]() The tendon and lining are covered by a series of thick, soft tissue called pulleys. The flexor tendons that bend the fingers have a lining on the outside. It can occur in both fingers and the thumbs, which have tendons that help them to bend. A trigger finger is a very common and treatable problem.
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