Trigger finger is a condition in which one of your fingers gets stuck in a bent position. Your finger may bend or straighten with a snap — like a trigger being pulled and released

Trigger finger is one of the very common conditions encountered by clinicians in their outpatient setting. According to a medical report1, as many as 2% in the population and 20% of the diabetic patients have trigger fingers.

What are Trigger Fingers?

Trigger fingers (妈妈手) is a type of finger problem that is mostly found in women above 40 years old and diabetics patients. It is a condition that makes your fingers or thumbs catch or lock when you bend them. The high risk groups those who type a lot on their computers and/or carry heavy loads. For example: labourers, mechanics, cleaners, factory workers and housewives. Housewives tends to carry heavy grocery with plastic handles which can cause direct impact to the tendons of the fingers. Librarians, magazine vendors and newspaper vendors are also at risk of trigger finger syndrome as they use their hands to carry and support heavy books and newspaper.

What Causes Trigger Finger?

“Triggering” describes the distinct catching or locking that occurs when the finger is bent or straightened. This condition involves the pulleys and tendons which bend the fingers. The tendons usually glide through the pulleys in the finger. When the pulley at the base of the finger becomes too thick, it constricts the tendon and a tendon nodule forms. This size mismatch prevents smooth gliding of the tendon. The pulley “catches” the tendon and results in triggering.

Would Therapeutic Massage Help with The Condition?

When there is acute inflammation or the onset is recent after injury, one should not receive aggressive massage. Once we rubbed or pressed too hard on the affected area, this could cause worsening of the inflammation and more pain with more swelling.

How Is Trigger Finger Treated?

Wearing a splint may help while medication therapy such as using anti-inflammatory NSAID such as Arcoxia and Celebrex can also be used to treat trigger fingers.

This is followed by intense hand therapy to stretch the tendon to reduce chance of re-swelling of the respective area and minimise the recurrence of the triggering effect of the tendon swelling.

What Happen If the Condition is Left Untreated?

Trigger finger if left untreated, can lead to contracture and permanent stiffness of the finger.  This means that the function of opening and closing the hand via bending and extending the finger is affected – weakness of grip and use of hands.

Once it forms contracture and permanent stiffness, patient would need open surgery to cut away the contracture and scarring in the pulley and tendon.  There would need long periods of post treatment rehabilitation such as physiotherapy to stretch and strengthen the tendon again.

Hence, in some trigger fingers, despite repeated injections to reduce the swelling and inflammation of the affected area, there might be a role for open surgical decompression of the hardened scarred pulley and tendon.

Reference:

  1. Fitzgibbons PG, Weiss AP. Hand manifestations of diabetes mellitus. J Hand Surg Am. 2008 May- Jun;33(5): 771-5.