2 July 2021

Trigger finger: what is it?

cause del dito a scatto

Symptoms, causes, diagnosis and treatment of stenosing tenosynovitis, commonly known as ”trigger finger”.

The trigger finger (stenosing tenosynovitis) is an inflammatory pathology that affects the digital flexor tendons.  The tendons, which connect the muscles to the bone starting from the forearm, passing through the wrist and reaching the fingers, are covered by a protective membrane called synovial sheath. This sheath produces a lubricating liquid that facilitates the movement of the tendon, allowing it to bend and extend normally, and therefore to flex the fingers. If the sheath is subject to an inflammation, a swelling can occur narrowing the channel through which the tendon passes and, as a consequence, its motion could be limited.  In this case the finger remains bent and in order to stretch it completely, a force traction must be applied, the so-called “trigger”. This movement causes discomfort and pain, and creates more inflammation and swelling, creating a vicious circle: trigger finger, sheath inflammation, difficulty moving the tendon, trigger finger, etc.

Symptoms

The fingers most affected by this disorder are the thumb, middle and ring finger.  Symptoms are evident: inability to stretch or to flex a finger, pain, swelling, feeling of heat, “snapping” feeling during movements.

What are the causes of the trigger finger?

The main causes can be:

  • Microtrauma of the hand.
  • Functional overload: repeated gripping movements can cause inflammation (e.g. musicians, construction workers).
  • Age and sex: stenosing tenosynovitis mostly affects individuals between 40 and 60 years of age, mostly women.
  • Presence of other diseases: people with diabetes, rheumatoid arthritis, and gout are more likely to develop this disorder.

Diagnosis

This disease can be diagnosed with the medical history and physical examination performed by the physician to assess the mobility of the fingers, the presence of pain and any subcutaneous nodules.

Treatment

The treatment depends on the severity and stage of the disease.  The goal of the therapy is to reduce inflammation and restore proper finger movement.  At first, it is possible to try using a brace and administer anti-inflammatory drugs and local infiltrations. If symptoms persist mini-invasive surgery may be necessary in an outpatient regimen.

UPMC Institute for Health Chianciano Terme hosts an orthopedic outpatient clinic for diagnosis and surgical treatment of diseases of the hand and wrist.

For further information: +39 0578 61198