What Is Trigger Finger? Understanding the Condition

How do you define a Trigger Finger?

Trigger finger, also known as stenosing tenosynovitis, is a condition that primarily affects the fingers and can be a source of discomfort or pain for individuals. It typically occurs when the flexor tendon sheath in the affected finger becomes inflamed or thickened, making it difficult for the tendon to glide smoothly within the sheath.

Causes of Trigger Finger

• Overuse injury - movements such as typing, gripping tools, or playing musical instruments
• Aging - the tendons naturally thicken and lose flexibility
• Certain conditions - such as diabetes, rheumatoid arthritis, and gout
• Hand Trauma - including fractures or direct trauma to the tendon sheath

 

Symptoms of Trigger Finger

• Finger Stiffness
• Finger Pain
• Tenderness at the base of the affected finger or near the palm
• Catching or Popping Sensation
• Limited Range of Motion
• Swelling
• Finger Locking in a bent position

 

Diagnostic Tests

To confirm the diagnosis, the physiotherapist performs specific clinical tests, including:

Finklestein Test:

This test is used to evaluate pain and discomfort in the hand and wrist, typically associated with conditions like De Quervain's tenosynovitis. While not specific to trigger finger, it helps rule out other potential causes of hand and wrist pain.

Passive and Active Range of Motion:

The physiotherapist assess the finger's ability to flex and extend through passive and active movements, looking for any restrictions or triggering.

 

Differential Diagnosis

 

 

 

Physiotherapy Treatment Options

Physiotherapy can be an effective non-surgical treatment option for trigger finger, especially in the early stages or for mild to moderate cases. Here's an overview of physiotherapy treatments for trigger finger:

Range of Motion (ROM) Exercises:

Physiotherapists often prescribe specific exercises to improve the range of motion in the affected finger. These exercises help maintain flexibility in the finger and prevent it from becoming stiff.

Finger Flexion and Extension:

1. Start with your affected finger straight.
2. Slowly bend the finger at the middle joint, bringing it towards your palm. Hold for a few seconds.
3. Then, slowly straighten the finger, extending it fully.
4. Repeat this flexion and extension movement 10-15 times for each finger, including the affected one.

 

Finger Abduction and Adduction:

1. Begin with your fingers together.
2. Spread your fingers apart as far as comfortably possible, then bring them back together.
3. Perform this abduction and adduction movement 10-15 times for each finger, including the affected one.

 

Finger Circles:

1. Hold your affected finger with your opposite hand's thumb and index finger.
2. Gently and slowly move your affected finger in a circular motion, both clockwise and counterclockwise.
3. Perform 10-15 circular motions in each direction.

 

Passive Stretching:

1. Using your opposite hand, gently and carefully stretch the affected finger by bending and straightening it. Do not force the finger.
2. Hold the stretch for a few seconds and repeat 10-15 times.

 

Finger Tapping:

1. Lightly tap the affected finger against a soft surface, such as a cushion or your opposite palm.
2. This tapping motion can help improve circulation and reduce stiffness.

 

Finger Pulleys (if recommended by a physiotherapist):

1. Some individuals may benefit from using finger pulleys, which are specialized devices designed to facilitate finger exercises.
2. These devices can help improve finger mobility by providing controlled resistance during flexion and extension movements.

 

Strengthening Exercises:

Strengthening exercises target the muscles and tendons in the hand and forearm, which can help improve finger strength and reduce strain on the affected tendon.

Finger Squeezes:

1. Place a soft, stress ball or foam ball in the palm of your hand.
2. Squeeze the ball as tightly as you comfortably can using all your fingers, including the affected one.
3. Hold the squeeze for a few seconds, then release.
4. Repeat this exercise 10-15 times with each hand.

 

Finger Resistance Bands:

1. Secure a resistance band around all your fingers, including the affected one.
2. Keeping your fingers straight, spread them apart against the resistance of the band.
3. Hold the stretch for a few seconds, then release.
4. Repeat this exercise 10-15 times.

 

Finger Opposition:

1. Touch the tip of your thumb to the tip of each finger, one at a time, including the affected finger.
2. Apply gentle resistance by pressing your thumb and finger against each other.
3. Hold for a few seconds, then release.
4. Repeat this exercise for each finger, performing 10-15 repetitions.

 

Finger Tapping (on a Table or Firm Surface):

1. Place your hand, palm down, on a flat surface like a table.
2. Begin tapping your fingers, one at a time, starting with your pinky and working your way to the thumb.
3. Tap each finger against the table with enough force to provide resistance but without causing discomfort.
4. Repeat this exercise for each finger 10-15 times.

 

Finger Pinch Grip:

1. Hold a small object, like a coin or a peg, between the thumb and the affected finger.
2. Squeeze the object tightly for a few seconds, then release.
3. Repeat this exercise 10-15 times.

 

Finger Push-Ups (if recommended by a physiotherapist):

1. Place your hand, palm down, on a flat surface.
2. Keeping your fingers straight, push your body weight up slightly by lifting your palm off the surface.
3. Lower your hand back down slowly.
4. Repeat this exercise 10-15 times.

 

Stretching Exercises:

Gentle stretching exercises can help alleviate tension in the affected finger's flexor tendon and improve its mobility.

Finger Extension Stretch:

1. Start with your affected hand palm-up.
2. Gently use your opposite hand to bend the affected finger backward at the middle joint, gently stretching it.
3. Hold the stretch for 15-30 seconds.
4. Repeat this stretch 2-3 times for each finger, including the affected one.

 

Finger Flexor Tendon Glide:

1. Begin with your affected hand palm-up.
2. Using your opposite hand, gently push the affected finger's fingertip toward the base of the finger, bending it at the middle joint.
3. Hold for a few seconds, then gently release.
4. Repeat this glide movement 10-15 times for each finger, including the affected one.

 

Finger Abduction Stretch:

1. Start with your affected hand palm-up.
2. Gently use your opposite hand to spread the affected finger apart from the adjacent finger.
3. Hold the stretch for 15-30 seconds.
4. Repeat this stretch 2-3 times for each finger, including the affected one.

 

Thumb-to-Finger Stretch:

1. Begin with your affected hand palm-up.
2. Touch the tip of your thumb to the tip of each finger, one at a time, including the affected one.
3. Gently press the thumb against the finger to stretch it.
4. Hold the stretch for 15-30 seconds for each finger.

 

Finger Circles:

1. Hold the affected hand in front of you with your fingers extended.
2. Slowly make circular motions with the affected finger, both clockwise and counterclockwise.
3. Perform 10-15 circular motions in each direction.

 

Finger Opposition Stretch:

1. Touch the tip of your thumb to the tip of each finger, including the affected one.
2. Gently press the thumb and the affected finger against each other to create a stretching sensation.
3. Hold the stretch for 15-30 seconds for each finger.

Finger Flexor Tendon Self-Massage (gentle):

1. Using your opposite thumb and forefinger, gently massage the palm side of the affected finger's tendon sheath, applying light pressure.
2. Massage in a circular motion along the length of the tendon sheath.
3. Repeat for 2-3 minutes, 2-3 times a day.

 

Manual Therapy:

Tendon Gliding Exercises:

These exercises involve gentle, controlled movements of the affected finger's tendon and are often performed under the guidance of a physiotherapist. The aim is to improve the gliding of the tendon within its sheath, reducing friction and discomfort.

 

Joint Mobilization:

Physiotherapists use manual techniques to mobilize the finger joints, helping to restore normal joint movement. This can be especially helpful if joint stiffness or dysfunction is contributing to trigger finger symptoms.

 

Soft Tissue Massage:

Therapists may employ specific massage techniques to address muscle and tendon tightness or to break up adhesions in the affected area. Massage can help reduce pain and promote blood flow for healing.

 

Myofascial Release:

This technique focuses on releasing tension and restrictions in the fascia, the connective tissue that surrounds muscles and tendons. By releasing fascial restrictions, physiotherapists aim to improve finger mobility and reduce discomfort.

 

Strain-Counterstrain Technique:

This gentle method involves finding and holding specific positions that reduce tension and pain in the affected finger's muscles and tendons. It's particularly useful for relieving muscle spasms and discomfort.

 

Passive Stretching:

Physiotherapists can gently manipulate the finger through its range of motion, stretching the tendon and joint to improve flexibility and reduce stiffness.

 

Trigger Point Release:

Trigger points, which are localized areas of muscle tightness and tenderness, can be addressed through manual therapy techniques. The physiotherapist applies pressure to these points to release tension and alleviate pain.

 

Electrotherapy:

Heat and Cold Therapy:

The application of heat or cold to the affected area can help alleviate pain and reduce inflammation. The physiotherapist may recommend alternating between hot and cold treatments.

 

Ultrasound Therapy:

Ultrasound therapy involves the use of sound waves to generate heat and promote circulation in the affected area. It can help reduce pain and inflammation.

 

Kinesio Taping and Splinting:

In some cases, physiotherapists use kinesio taping techniques or recommends splinting to support the affected finger in a neutral position, allowing the inflamed tendon sheath to rest and heal.

Support and Rest for the Affected Finger:

To start, the physiotherapist ensures that the affected finger is in a neutral or slightly extended position, which helps reduce tension on the flexor tendon.

Then the physiotherapist applies the kinesio tape carefully, typically in a manner that encourages the affected finger to remain in this position.

 

Tension Reduction:

Kinesio tape is designed to be elastic and flexible, allowing for controlled movement while reducing excessive tension on the flexor tendon.

By applying the tape in a specific manner, the physiotherapist can help counteract the forces that contribute to trigger finger, particularly the constriction of the tendon sheath.

 

Pain Reduction and Inflammation Control:

Kinesio tape can aid in reducing pain and inflammation by gently lifting the skin and promoting improved circulation in the affected area.

This lifting effect can also help alleviate pressure on the nerves, contributing to pain relief.

 

Facilitating Tendon Gliding:

The physiotherapist uses kinesio taping to encourage smoother gliding of the affected tendon within its sheath.

This can help reduce the "catching" or "locking" sensation commonly associated with trigger finger.

Additionally, kinesio taping is often used in conjunction with other physiotherapy modalities, exercises, and interventions to provide a comprehensive approach to trigger finger management. The overall goal is to reduce pain, improve finger mobility, and enhance the patient's quality of life.

 

Unlocking a Trigger Finger:

It typically involves relieving the restriction or catching of the affected flexor tendon within the tendon sheath. Here are some steps you can try to help unlock a trigger finger: