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Conditions Fingers

What Is Trigger Finger and How Is It Treated?

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what is trigger finger

If you’ve seen people with what looks like permanently bent fingers, such as the ones in this picture, they may have a condition called “trigger finger.” The name comes from the resemblance of the index finger holding a gun. In this blog, we’ll talk about what is trigger finger and how it can be treated.

Trigger finger (Stenosing Tenosynovitis) occurs when the fingers are either locked in place or when they “catch” in place as you bend them. Trigger finger is due to inflammation of the tendons on the finger and/or thumb.

As you may know, the job of the tendons is to connect the muscles and bones. Tendons allow for movement of the arms, hands, and fingers. Normally, they work smoothly due to their natural lubrication; however, if the tendon is swollen, it can cause the finger to catch and stick when it is bent.

 

Why Does Trigger Finger Occur?

A number of different variables can increase the risk of developing trigger finger including having rheumatoid arthritis, diabetes, and/or gout. Those who hold an object in the same position for a long period can also aggravate the tendons and increase their likelihood for developing this condition over time. Repetitive and forceful movements, such as playing electric guitar, can cause the condition to occur as well.

Trigger finger affects people in many industries and walks of life. Those who perform repetitive tasks with their fingers and thumbs are at the greatest risk. Women seem to suffer from the problem more than men, and it tends to happen most often in those who are between 40 and 60.

why does trigger finger occur?

Understanding the Trigger Finger Symptoms

Those who may suffer from trigger finger will likely notice that the base of their finger (or thumb) is sore. Of course, this symptom alone does not mean that you are going to have the condition and that’s why it’s so important to receive a proper diagnosis from a doctor.

Here’s a list of trigger finger symptoms to look for:

  • Finger stiffness, especially when first waking up in the morning
  • Pain when bending or straightening the finger(s)
  • Hearing a clicking or popping sound from the affected fingers
  • Painful bumps at the base of your finger
  • Fingers stuck in a bent position

 

Treatment for Trigger Finger

The first course of treatment recommended by most doctors is to rest the affected fingers, as this can help to relieve the inflammation on the tendon.  In some cases, a hand specialist like Dr. Arora, might want to splint the finger, as this will keep you from inadvertently moving the joint. Many times, with rest, this can remove the problem. If the problem persists, though, the doctor might prescribe medicine to help keep the inflammation down or a steroid injection. In some severe cases, the doctor may recommend hand surgery.

The recovery time for trigger finger will vary based on the type of treatment and the severity of the case. Those who take anti-inflammatory drugs and rest the finger can resolve the issue in a few weeks. Splinting could take several weeks as well. Those who have surgery will likely have a longer recovery period, as they have to consider the recovery time of the incision. Even though an incision for this type of surgery is typically small, it can still be tender for some time after the surgery.

If you believe you are suffering from trigger finger, and you have found that resting doesn’t help, it may be time to get in touch with top MI hand surgeon Dr. Avery Arora. You can schedule an appointment at one of his four offices in West Bloomfield, Warren, Macomb, or Howell, Michigan.

 

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Hands

Common Causes of Stiff Hands

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Stiff hands can occur due to overuse and medical conditions, as depicted in this image of a man holding his hand in pain.

Stiff hands can hit you all of a sudden. One minute you’re going about your day and the next, you’re wiggling your wrists in hopes of bringing life back into your fingers.

Certain serious medical conditions can definitely bring this on, but in other cases, your hands may feel stiff for no apparent reason.

Well, there most likely is a reason why your hands are stiff, and self-care may be your first line of treatment and prevention.

5 Common Causes of Stiff Hands

Stiffness in your fingers, thumb, and palm occur when there is a problem in a joint, including the ligaments and muscles.

One of the greatest culprits is arthritis, which isn’t a condition as much of a description of more than 100 types of ailments. Types of arthritis that may lead to stiff hands include:

Other medical conditions that can contribute to the sensation include:

Environmental factors and how you use your hands may lead to stiffness as well, such as gaming for too long or spending too much time outside in freezing temperatures.

Questions and Answers

Whether your hands become stiff temporarily for a few minutes or it’s an ongoing symptom, the reasons why this happens can be mysterious. When you see Dr. Arora, tell him about your symptoms in detail, and he will help identify the source of your problems.

In the meantime, here are some of the common questions we hear about hand and joint stiffness along with the basic answers.

Why do my hands get stiff in the morning?

One of the simplest answers is that you slept on them or leaned on them too much as you were sleeping. Avoid leaning on your wrists or tucking your hands under your head as you sleep. Using a brace at night may help you keep your wrists straight.

Otherwise, a common cause of stiff hands in the morning is worn joints or muscle tightness. This may be an indicator of arthritis, but not necessarily. Over the course of your life, your joints experience a lot of wear-and-tear; specifically, the cartilage in your joints dries out, stiffens, and loses lubrication.

This can lead to weaker muscles and stiff tendons, which may tighten even more as you sleep because you’re not moving. Lack of movement allows fluid to build up, which can stiffen tissues. When we move, bodily fluids move through the body more evenly, which can increase flexibility.

Simple lifestyle changes may help combat stiffness in your hands in the morning, including using proper mattresses and pillows, avoiding cold temperatures, staying hydrated, and maintaining a healthy diet. You also should get regular exercise that is ideal for your body’s needs, so talk with Dr. Arora about stretches and exercises you can do to strengthen the muscles in your hands.

Why are the symptoms bad at night?

Just like our eyes and legs, our hands get a lot of use during the day. For that reason, you may feel more stiffness, pain, or throbbing in your hands in the evenings. Resting your hands will help them recover from the everyday grind. That’s the simple answer.

Otherwise, if your hands get stiff while you sleep, it could be a sign of a more serious condition, so talk with Dr. Arora about your symptoms.

Why does cold weather make my fingers stiff?

Momentarily, that’s actually a good sign; it means your body is working as it should. Our fingers and toes are designed to protect the rest of our bodies. In the cold, our blood vessels constrict to keep the core of our bodies and our vital organs warm. That may leave our fingers and toes colder and stiffer.

If you keep that up too long, though, you may experience frostbite in your extremities, which can be very dangerous. Help your body stay warm in the cold by wearing gloves, thick socks, and boots, as well as hats that can cover your ears. If they become wet, change into dry clothing as soon as possible. If you are outside shoveling or playing in the snow, go indoors every 15 minutes or so to warm up.

How do you treat stiff hands?

Treatment for stiff hands will depend on its causes, but some home remedies may help.

  1. Ask our hand therapist, Lodia, about hand exercises that can help you stimulate your blood flow in the morning or relieve overuse symptoms in the evening.
  2. Over-the-counter anti-inflammatory medications may help relieve swelling that is causing stiffness in your hands. Talk with Dr. Arora to determine if this will help you. He may have specific medications that would be preferable in your case.
  3. You can use a brace while you sleep, while participating in hobbies, or at work if your job requires intense use of your hands.
  4. Gently stretch your hand muscles to loosen them. Ask Dr. Arora or Lodia about how to loosen up your hand muscles safely.
  5. Take a lukewarm shower or bath to relieve stiff joints. Avoid water that is too hot, as this can dry your skin, which could make your hands feel tighter.
  6. Use a warm compress or heating pad for only several minutes to relieve stiffness. Be sure to wrap the heating device in a towel before placing it on your skin to avoid burns or swelling.

Diagnosis and Treatment

The first step is to determine why you are experiencing stiff hands. Once the cause is identified, we can advise you on the best course of action, whether it’s simple self-care, hand therapy, medication, or the use of support devices. Surgery may be required in some more serious cases when other remedies do not help.

If your stiff hands are regularly causing you discomfort or you are concerned that this may be due to a serious medical condition, call us to schedule an appointment with Dr. Arora. We will help you identify the cause of your hand symptoms and devise a treatment plan that works for you.

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Fingers General

Dupuytren’s Contracture vs. Trigger Finger: What is the Difference?

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There are a number of differences in Dupuytren's contracture vs. trigger finger.

When it comes to Dupuytren’s contracture vs. trigger finger, the differences are not always clear. On the surface, they have similar effects on the fingers. When you look deeper, however, you will see that the reason why the fingers are functioning the way they do is different.

Facts about Dupuytren’s Contracture vs. Trigger Finger

It’s easy to see why people may confuse the two conditions. They are similar in some ways. First of all, both conditions can affect any finger. Another similarity is the appearance. The affected fingers are typically curved inward toward the palm, although in some cases they can be bent to the left or right.

Otherwise, they are very different conditions. Following is a breakdown of the differences in Dupuytren’s contracture vs. trigger finger.

What is Trigger Finger?

The technical name for trigger finger is stenosing tenosynovitis. Trigger finger is caused when an injury causes a finger to get stuck in a bent position. This occurs when inflammation narrows the sheath around the tendons, leading to the formation of a nodule. When you flex this finger, the nodule must slide through the narrow sheath, causing a snapping sensation.

Treatment for trigger finger may include:

  • The use of medications to relieve pain
  • Therapy that includes rest, stretching exercises, and the use of a splint
  • Steroid injections
  • A percutaneous release procedure, where the hand surgeon uses a needle to break apart the constriction that is blocking proper movement
  • Surgery to loosen the constricted area
Trigger finger is usually caused by an injury and is most common in the thumb, index finger, and middle finger.
Trigger finger is usually caused by an injury and is most common in the thumb, index finger, and middle finger.

What is Dupuytren’s Contracture?

Dupuytren’s contracture develops over time. It begins when tissue forms knots under the skin of the palm. As these knots form, they create a cord that pulls the fingers into a bent position. Everyday activities like gripping silverware can become difficult with this condition.

Similar to one of the trigger finger treatment options, Dupuytren’s contracture can be treated with the needling procedure to break the cord of tissue that is causing a finger to contract. Other treatment options include self-care, Xiaflex enzyme injections, and surgery.

Surgery for Dupuytren’s contracture entails removing all the tissue that is affected, including the skin. A skin graft may be required to repair the wound. Because this is a serious procedure with a lengthy recovery time, it is ideal only for those who have a diminished quality of life due to the condition.

Dupuytren’s contracture develops over time and stems from the tissue in the palm.
Dupuytren’s contracture develops over time and stems from the tissue in the palm.

Differences Between the Two Hand Conditions

Following are some of the primary differences in Dupuytren’s contracture vs. trigger finger.

  1. Trigger finger starts with the fingers while Dupuytren’s contracture stems from the palm.
  2. Dupuytren’s contracture involves the tissue, but trigger finger involves the tendons.
  3. Trigger finger is most common in the thumb, index finger, and middle finger. Dupuytren’s contracture is most likely to occur in the fourth finger and the pinky.
  4. Someone who has trigger finger can straighten the finger if they tried, but someone with Dupuytren’s contracture cannot.
  5. Whereas trigger finger is usually the result of an injury, the causes of Dupuytren’s contracture are not clear.

If you have experienced a recent injury that led to trigger finger or have been seeing the effects of Dupuytren’s contracture progress over a number of years, see our hand specialist in Macomb, Warren, West Bloomfield, or Howell for treatment. Make an appointment by calling our office or sending our hand surgery team a message online.

 

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Fingers General

Which Form of Trigger Finger Treatment is Right for Me?

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Trigger Finger

Trigger finger is a condition that causes the fingers, and sometimes the thumb, to have a tendency to lock in place when they are bent. It is sometimes accompanied by popping and cracking while attempting to bend or straighten the fingers. In addition, it can be very painful at times.

Running through the fingers, just like in other parts of the body, are tendons that serve the purpose of connecting muscle to bone. These tendons will slide through a sheath, which is tissue that covers the tendon. The sheath contains a lubricating membrane to help the tendon move more easily. Trigger finger can develop when these tendons become inflamed. When this happens, the tendons can become swollen. This makes it harder for the tendon to move through the sheath. When this goes on for a period of time, the sheath can develop scar tissue, the result of which is a narrowed opening for the tendon to slide through. The resulting difficulty can cause popping and cracking as the tendon is pulled through restricted space.

Trigger finger can be caused by one of several factors. Health conditions like gout, diabetes or rheumatoid arthritis can lead to its development. It can also be caused by repetitive motion, especially if the motion is accompanied by forceful gripping. Sometimes, it becomes so hard to straighten the fingers that the other hand must be used to help.

If you suspect that you might have trigger finger, our team can perform a diagnosis rather easily. Once trigger finger is diagnosed, treatment may be done by a variety of methods. Usually, we will start with more conservative measures and progress to more extensive treatments only if the conservative methods do not work.

Trigger finger treatment may involve the use of a splint, anti-inflammatory medications or steroid injections, among other things. Often times, a combination approach is taken. If these more conservative measures don’t get the job done, surgery may be the next step. Most people, however, will not need surgery, but this obviously depends on the situation. The recovery time and results depend on the severity of the condition.

If you suspect that you may be developing trigger finger, you should seek help from the team at Arora Hand Surgery sooner rather than later. This will improve your chances of having success with conservative treatments. Our offices are located in West Bloomfield, Howell, Warren, and Macomb. Contact us today to schedule a consultation!

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Fingers General

Symptoms of Trigger Finger

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Trigger finger

Trigger finger, more formally known as stenosing tenosynovitis, is a condition in which a finger or the thumb gets locked in a bent position. The condition is more common in women than in men.

What are the Symptoms?

The affected finger may suddenly snap straight, like a trigger being pulled and released. Alternatively, the patient may not be able to straighten their finger at all. The patient may also feel discomfort or a lump at the base of the finger. Other symptoms can include limited mobility of the affected digit, a clicking or popping noise when the finger does move and pain.

What Causes Trigger Finger?

The fingers and thumbs have tendons that pass through sheaths or pulleys that keep the tendon close to the finger bone. If the sheath gets inflamed or irritated, it swells and thickens, which prevents the tendon from moving normally. If the condition isn’t treated, the sheath develops scars and nodules that make the sheath even more abnormally thick. This impairs the finger’s mobility even more.

Trigger finger is more common in people with certain health problems, such as diabetes or rheumatoid arthritis. Occupations and activities that require repeated strong gripping can increase the chances of developing trigger finger. For example, anybody who uses a screwdriver a lot might develop trigger finger.

How is Trigger Finger Treated?

There are many possible treatments for trigger finger. In a lot of cases, Dr. Arora will start by simply recommending that the patient rest the affected hand for at least four weeks. He may also recommend anti-inflammatory medication.

Our doctor may also splint the patient’s finger to keep it straight. In some cases, the patient will wear the splint only at night to avoid curling their fingers into a fist while sleeping. The patient may wear the splint for up to six weeks. Dr. Arora may also recommend gentle stretching exercises to improve the finger’s mobility.

If none of these methods prove helpful, our doctor may recommend a steroid injection near or directly into the affected sheath to reduce swelling and let the finger move freely again. Steroid injections are the most common treatment for trigger finger, and they work for about 90 percent of non-diabetic patients. The injection works for about 50 percent of the patients with diabetes.

An outpatient procedure in which the doctor breaks apart the constriction is often necessary if non-surgical treatments have failed. In severe or stubborn cases, our doctor may perform surgery on the affected tendon sheath.

Learn More During a Consultation

There is no one-size-fits-all treatment for trigger finger, as the best treatment option will depend on the unique situation. Make an appointment at Arora Hand Surgery in West Bloomfield, Howell, Warren, or Macomb so that our team can assess your condition and come up with a treatment plan for relieving you of your symptoms. Contact us today to schedule a consultation.

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Fingers General

When You Have Trigger Finger

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If you understand that your fingers are constructed of pulley-like tissue known as tendons, and that these are what bend and flex the thumb and fingers, it is a very helpful visual for a diagnosis of trigger finger. This is because the condition, which is technically known as stenosing tenosynovitis, occurs when one of the pulleys at the bottom of a finger (or thumb) thickens and can no longer move fluidly. Essentially, it will lock the finger in an unnatural, curved position, and become an ongoing and worsening condition.

To envision what is happening when you suffer trigger finger, try to envision a series of pulleys, which are ring shaped structures through which ropes run in order to lift or move objects. So, your finger is a series of bones, and connected to them are those pulleys, and through those pulleys run tendons that connect to muscles and which cause the fingers to bend and flex when needed.

Imagine if a pulley at the bottom of a finger got clogged with a sticky residue that caused the tendon to catch or be unable to glide freely through the pulley. This would cause the tendon to become irritate with repeated catching issues, and this irritation would lead to swelling. This is what happens with trigger finger, and eventually, the tendon below the lowest pulley will swell to such as degree, or even form a nodule, that it cannot pass back upward through the pulley. This locks the finger in that hooked position, that looks similar to someone pressing the trigger of a pistol.

Why Does This Happen?

Obviously, it makes many wonder why the pulley would swell in the first place, and experts are not quite sure on the underlying cause. (ASSH.org, 2015) Some patients with arthritis may get this condition, and some with diabetes or gout will develop it. However, there are some who suffer trigger finger without any apparent cause, though trauma to the hand does seem to be related to the development of some cases.

It doesn’t happen instantly, though, and there are indicators that you may be developing trigger finger. You may have discomfort in your palm or tenderness when pressure is applied. Additionally, the sensation of the middle or large knuckle catching is often an indicator (though it is not the precise location of the problem) that trigger finger may be developing.

Trigger Finger Treatment

How does a hand doctor unlock this caught tendon? The first steps are to attempt to reduce the swelling and allow the tendon to begin moving freely again. This can often be done with a combination of splinting and anti-inflammatory medications. Injectable steroids may also be used to release or reduce the swelling. Should these conservative efforts fail, the next step is to perform a surgical release that opens the pulley and allows the tendon to return to its normal position.

Any treatment must be done by a hand doctor, and therapy is often required to ensure that the problem has been resolved and that the pulley is no longer causing the tendon to be captured.

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Dr. Aroras office from my first call to schedule my appointment was friendly. Walking in the first day, I felt like I was in a nice atmosphere. Dr. Arora was EXCELLENT in taking great care of my hand injury. He was gentle and very understanding to the concerns I had about my hand. His expertise was admirable and I would recommend anyone with an injury to their hand to his office to be under his care. Because of him, I have healed faster than expected and will make an 100% recovery! Thank you Dr.

Jackie S.

I first thought I was going to have to have painful injections or surgery, but Dr. Arora suggested physical therapy may do the trick. I was doubtful, but I agreed to do it. Now, my pain is gone, and with the help of an ergonomic keyboard at work to keep my hands in the correct position, I am virtually pain free. The therapy strengthened my wrists and shoulders, and built more flexibility into my wrists.

Jerry T.

My experience with this doctor was positive from the outset. Dr. Arora was kind and spent a great deal of time with me. Staff was friendly. The office was nice and bright.

Ariel G.

Very friendly and helpful Great staff!!! Doctor Arora was very professional and did great work. I was very happy with everything!

L B.