(Stenosing Tenosynovitis; Volar Flexor Tenosynovitis)
Tendons connect bones to muscles in the body. Flexor tendons of the thumb and fingers pull the fingers into a fist. The tendons are enclosed in a synovial sheath. When this sheath becomes inflammed it is called trigger finger.
Usually, tendons slide easily through the sheath as the finger moves. In the case of trigger finger, the synovial sheath is swollen. The tendon cannot move easily. This causes the finger to remain in a flexed (bent) position. In mild cases, the finger may be straightened with a pop. In severe cases, the finger becomes stuck in the bent position. Usually this condition can easily be treated. Contact your doctor if you think you may have trigger finger.
Often, the cause of trigger finger is unknown. However, many cases of trigger finger are caused by one of the following:
The following factors increase your chance of developing trigger finger:
- Age: 40 to 60
- History of repetitive hand motions for work or play
- Sex: female
History of certain diseases:
- Rheumatoid arthritis
If you experience any of these do not assume it is due to trigger finger. Some of these symptoms may be caused by other health conditions. If you experience any one of them for a period of time, see your physician.
- Finger or thumb stiffness
- Finger, thumb, or hand pain
- Swelling or a lump in the palm
- Catching or popping when straightening the finger or thumb
- Finger or thumb stuck in bent position
Your doctor will ask about your symptoms and medical history. A physical exam will be done. The physical exam may include:
- Asking you to move the affected finger or thumb
- Feeling the hand and fingers
For severe cases, your doctor may refer you to a hand specialist.
Talk with your doctor about the best plan for you. The goal of treatment is to reduce swelling and pain. This will allow the tendon to move freely in the sheath. Treatment options include the following:
Stopping movement in the finger or thumb is often the best treatment for mild cases of trigger finger. A brace or splint may be used. Rest may be combined with stretching the muscle tendon unit.
Several medications are used to treat tenosynovitis. These include:
Severe cases of trigger finger may not respond to medications. In this case, surgery may be used to release the tendon from a locked position. This surgery is usually performed on an outpatient basis. It only requires a small incision in the palm of the hand.
If you are diagnosed with trigger finger, follow your doctor's instructions.
American Academy of Orthopaedic Surgeons
American Society for Surgery of the Hand
The Arthritis Society
BC Health Guide, British Columbia Ministry of Health
Trigger finger. DynaMed website. Available at: http://www.dynamicmedical.com/dynamed.nsf?opendatabase . Accessed September 5, 2005.
Trigger finger. MayoClinic.com website. Available at: http://www.mayoclinic.com/invoke.cfm?id=DS00155 . Accessed September 5, 2005.
What is trigger finger? The Indiana Hand Center website. Available at: http://www.indianahandcenter.com/medical_trigger.html . Accessed September 5, 2005.
Last reviewed February 2009 by ]]>Robert E. Leach, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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