Trigger thumb and finger

Trigger thumb and finger (by Clare Black)

Trigger thumb and finger

Trigger Finger and Trigger Thumb

Mechanism of Injury

Trigger finger or thumb is often caused by repetitive activities involving forceful gripping and use of the hand. There are several factors that can increase the risk of developing the condition including diabetes and rheumatoid arthritis. It can occur simultaneously with carpal tunnel syndrome and is more common in women.

Trigger finger and thumb is due to inflammation of the tendon or its surrounding structures causing it to catch when moving through the protective sheath. If the trigger finger or thumb is severe, the digit can become locked in a bent position.

Photo source: Mayo Clinic

Symptoms

•   Catching sensation when bending or straightening the affected finger or thumb
•   Pain in the palm at the base of the finger or thumb
•   Thickening or a lump on the tendon
•   The thumb or finger can become locked in a flexed position
•   Swelling of the finger or thumb

Diagnosis

A diagnosis is made based on a physical examination. Tendon gliding is assessed by palpating in the palm and base of the affected digit as the patient bends and straightens their fingers and thumb while checking for pain, swelling, catching or a nodule on the tendon.

Referral

A referral should be made as soon as symptoms appear or are diagnosed.

Treatment

Treatment options for trigger finger and trigger thumb include:

•   Conservative management
•   Corticosteroid injection
•   Surgery

Conservative Management

•       A custom made thermoplastic finger or thumb based splint to limit range of motion and rest the affected tendon
•       Activity modification education to prevent catching of the tendon
•       Pain and oedema management
•       As pain and catching subsides a graded exercise program to regain movement and strength will be prescribed

Splinting

MCP Joint blocking splint for trigger finger

Controlled motion splint for the thumb allowing tendon glide without triggering