The term “trigger finger” is used to describe a condition characterized by the occurrence of a snapping or catching sensation during finger flexion. While it may initially seem reminiscent of a hunting-related ailment, this condition primarily affects individuals over the age of 40 who have comorbidities like diabetes or rheumatic diseases. However, it can also manifest in individuals of all ages, including newborns.
In younger individuals, trigger finger can be observed in sports enthusiasts who heavily utilize their palms, such as off-road cyclists, motorcyclists, or mountaineers.
How It Occured?
The exact etiology of trigger finger formation remains incompletely understood; however, the progression of the disease is well-documented. It is known that the tendons responsible for finger flexion and their respective sheaths are affected. Tendons serve as crucial structures that facilitate the connection between muscles and bones. Each tendon is enveloped by a protective sheath, and within this sheath, the tendon smoothly glides during finger movements.
The pathogenesis of trigger finger involves swelling and thickening of the tendon sheath due to inflammation, which subsequently impedes the tendon’s smooth gliding motion during finger flexion. Initially, individuals may experience symptoms such as reduced mobility and occasional relief through a popping sensation as a result of restricted movement in the affected area of the sheath. However, if left untreated and the condition progresses, the thickened sheath further compromises tendon movement, ultimately resulting in the finger becoming locked in a triggered position.
Diagnostic Process
X-rays are not utilized for the diagnosis of this condition. Instead, the physician conducts a thorough examination of the finger, assessing for detectable swelling, masses, or nodules. The affected finger may exhibit a tense and swollen appearance, with particular attention given to the joint closest to the palm.
Treatment Approaches
The primary objective of treatment is to alleviate swelling and restore proper finger mobility. Initially, conservative measures are employed, such as pharmacotherapy involving aspirin or ibuprofen to reduce inflammation, as well as the implementation of finger splints to facilitate rest. This initial phase is most suitable for cases characterized by sudden onset or recent manifestation.
In instances where symptoms persist, the second phase involves the administration of localized corticosteroid injections into the thickened segment of the tendon. The degree of relief experienced by individuals can vary, with the duration ranging from a few weeks to several months. Recurrence is a common occurrence. For subacute cases, which present within a timeframe of three weeks to three months, this stage may result in complete recovery, addressing symptoms such as pain and morning stiffness. However, the onset of finger locking may be delayed.
In situations where the condition is associated with diabetes, rheumatic diseases, or becomes chronic (persisting for more than three months), or frequent episodes of finger locking are encountered, surgical intervention becomes necessary. The procedure involves repairing the thickened section of the tendon, which ultimately leads to the restoration of normal finger movement. Following surgery, individuals may require postoperative physical therapy and rehabilitation sessions.
