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11 / 12 / 2017
Trigger Finger
 
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Trigger finger - stenosing tenosynovitis

 
 

What is Trigger Finger?

Trigger finger is a common disorder of the hand which causes a painful snapping or locking of the fingers or thumb. The medical name for this condition is stenosing tenosynovitis. Stenosing refers to the narrowing of an opening or passageway in the body. Tenosynovitis refers to inflammation of the outer covering of the tendons that bend and extend the fingers and thumb. The tendons are tough, fibrous cords that connect the muscles of the forearm to the bones of the fingers and thumb. This muscle and tendon system enables one to bend the fingers inward when making a fist, and extend them out straight.

The tendons glide through a protective covering called the tendon sheath. The sheath is like a tunnel, and is lined with a thin membrane called synovium. The synovial lining helps reduce friction as the tendons glide through the tendon sheath. Areas of dense fibrous tissue called annular bands or pulleys are also part of the tendon sheath. These structures are attached to the bones of the fingers and thumb, and hold the tendons close to the bones over which they pass. Your  Hand Center physician will review this anatomy with you during your office visit.

Trigger finger is often caused by inflammation of the synovial sheath surrounding the tendons. It may also result from enlargement of the tendon itself, or narrowing of the first annular band (A1 pulley).

When inflamed, the normally thin covering of the sheath may be thickened to several times its normal size. This reduces the amount of space through which the tendons are able to pass. The tendon is no longer able to glide freely through the sheath, and the tendon itself may swell up in a balloon-like mass at the point where it tries to pass through the tunnel.

Upon forceful bending of the finger or thumb, the enlarged portion of the tendon is dragged through the constricted opening. This motion is often accompanied by a painful snap, and the finger or thumb may be locked in a bent position. Straightening the finger or thumb may require using the non-affected hand to actually pull the finger back into an extended position, causing another painful snap as the swollen portion of the tendon passes back through the sheath.

A trigger finger (thumb) is a condition where the movement of the affected digit is arrested for a moment while flexed or extended and then continues with a jerk upon continued effort. This is a result of thickening and constriction of the mouth of the fibrous tendon sheath through which the affected tendon travels.  This interferes with the normal free gliding of the flexor tendon contained within the thickened sheath.

Trigger finger, also called as stenosing tenosynovitis. Treatment varies depending on the severity of the condition, and ranges from rest to medications to surgery.

What are the Causes?

The exact cause of trigger finger or thumb is not always readily apparent. In many cases, however, this condition may be the result of repeated strain of this area due to work or hobby activities. Tasks that require repetitive grasping or the prolonged use of tools (scissors, screwdrivers, etc.) which press firmly on the tendon sheath at the base of the finger or thumb may irritate the tendons and result in thickening of the tendons themselves or the tendon sheath. Symptoms of trigger finger may also be associated with conditions such as rheumatoid arthritis, gout, or metabolic disorders such as diabetes that produce changes in connective tissues and synovium.

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