5 STEPS TO UNLOCK YOUR TRIGGER FINGER.

WHAT TRIGGERED MY TRIGGER FINGER? 

How to treat your trigger finger at home.

Have you been noticing that when you try to straighten your finger it is stuck and you just cannot make it straight?  

Does your finger “pop” when you bend(flex)  and straighten (extend) your finger? Does your finger lock in a flexed position?  

Are you unable to flex your finger at all?  Do you need to use the fingers of your other hand to straighten your locked finger? 

Can you feel a “nodule” on one of your fingers?

As a physiotherapist I have worked with hundreds of patients with trigger finger over my twenty years in practice.  Most recently I had a fireman who came for treatment for his right third finger.  In fact, this was not his first time having a trigger finger.  Four years ago he had the same symptoms in his left hand.  He was able to get treatment and avoided surgery for his left hand.

However, this time he is having more pain, more swelling and frequent locking of his third finger in flexion.  He started treatment a few months ago but of course the demands of his work mean he needed to continue to use his hands and fingers daily at work.  Since his condition was much worse this time – he was referred to a hand surgeon and did have surgery on his third finger.

The surgeon released the pulley system in his finger with a small incision.  This is a procedure that the surgeon does in his office and you go home the same day with restrictions (no lifting more than 15 lbs for 10-14 days) and in 10 days the stitches are removed.  We are happy to say that his surgery was a success and he has been back to work since his surgery.

In this post we will begin by explaining exactly what trigger finger is and what is triggering it for you.  Then we will describe three exercises that you can do at home to treat your trigger finger.

What is a trigger finger? 

• Trigger finger, is a condition of the fingers and is also called “stenosing tenosynovitis”.  
• Every finger has a flexor pulley system that allows you to bend (flex) and straighten (extend) your fingers.  
• A narrowing of flexor pulley sheaths combined with hypertrophy and inflammation of the tendon and its covering (sheath) interface causes trigger finger 
•  Usually it begins as an odd ache in the palm during movement of the affected finger
• Gradually there is a snapping sound of the flexor tendon as the individual extends and flexes the digit.
• The inflammation may also cause the tendon to become nodular.

Facts about Trigger Finger

• Most common in adults age 40-50
• 2-3% of general population
• 10% of diabetic population

• It most commonly occurs in the ring finger and the thumb but can present in any finger
• Micro-trauma – repetitive use or compression leads to inflammation of the flexor tendon and its covering (sheath) 
• The finger feels like it is locking because the tendon is not sticking within its sheath 
• The mechanism that extends a finger is weaker – so that is why the finger can flex but does not have the strength to extend against the inflamed tendon and sheath
• This means that you CAN close your fingers but then you need to use your other hand to extend the trigger finger

• Can cause significant pain and functional impairment

What causes trigger finger?

• There are many causes for trigger finger
• Other illnesses can contribute such as: diabetes, amyloidosis, carpal tunnel syndrome, gout, thyroid disease, and rheumatoid arthritis. 
• Repetitive use of the finger can result in thickening and narrowing of the tendon and its sheath, leading to the tendon being unable to slide smoothly within its sheath. This results in catching and locking.
• In children, the aetiology appears to be developmental, with a mismatch in the size of the flexor tendon of the thumb and its tendon sheath.

The TRIGGER FOR TRIGGER FINGER? 

is repetitive use or compression to your finger or thumb 

Five Steps to Unlock your Trigger Finger

CAUTION:

DO NOT DO AN EXERCISE THAT TRIGGERS YOUR FINGER TO POP OR LOCK BECAUSE  EVERY TIME YOUR FINGER LOCKS IT IRRITATES THE INFLAMED AREA AND YOU DO DO NOT WANT TO DO THIS – YOU WANT TO REST THE AREA AND AVOID PROVOKING THE LOCKING SENSATION

`1. How to bring down pain and  swelling in the trigger finger

• It is important to decrease the inflammation on the tendon and its sheath -so that it can slide in and out of the pulley without locking
• Apply ice for several times a day using an ice pack and towel for 10 min
• You can rub the ice directly on the are swelling and pain for 2 minutes
• You can use finger splints designed to prevent flexing and extending of the finger

2. Active ranges of motion of my trigger finger

• Open and close your fingers as fully as you can in PAIN FREE ranges
• You should NOT cause your finger to lock and force it to unlock
• Do this 10-20 times and do this 4 times a day

3. Massage to the nodule of the trigger finger

– find the painful nodule and press on it in different directions as firmly as
you are able to tolerate 

– massage the “web” space on either side of your trigger finger

– do this for 2-3 minutes and do this 5 times a day or more as tolerated

4. Stretching your forearm muscles to help your trigger finger

– first bend your elbow by your side at 90 degrees and bend your wrist so
fingers point up to the sky then use your other hand to stretch all fingers
and thumb towards yourself – hold 30 seconds and do 30 times – do this 3
times a day

– now repeat this with your wrist in the opposite direction so your fingers
point to the ground and press with your other hand – same instructions

– if this is not painful – then do the same but hold your arm so your elbow is
straight and repeat the same

5. Strengthening exercise to help your trigger finger

– place a rubber band around your fingers while they are flexed and then try
to stretch the rubber band by extending your fingers 

– make sure this is NOT painful and is NOT causing your finger to lock

Frequently Asked Questions

Question: When should I see my physiotherapist or chiropractor for my trigger finger?
Answer: We recommend that you DO NOT IGNORE hand pain.  If you have some symptoms, drop in to see your physiotherapist  or chiropractor.  We are trained to assess your hand and come to a proper diagnosis.  There are other conditions that could be more serious.  Early treatment will lead to a better outcome for you.

Question: What happens if the trigger finger goes untreated?
Answer: In most cases, trigger finger limits your movements and gets in the way of your daily functional activities.  BUT, if it is not treated it is possible that the affected finger or thumb may become permanently stuck in flexion.  This will make it impossible to do your daily activities and then you may require surgery to unlock your finger or thumb so you can have full function of your hand. 

Question: Should I wear a trigger finger splint all day?
Answer: There are many different trigger finger splints.  Some of them will not allow ANY movement of the finger or thumb.  These are worn at night so that your finger/thumb can rest but must be removed during the day for you to use your hand.  Others will allow partial movement and can be worn during the day.  Discuss splinting options with your therapist and you can learn about your options.