From the Guidelines
Trigger finger is characterized by a finger or thumb that gets stuck in a bent position and then suddenly pops straight, similar to a trigger being pulled and released, with main symptoms including pain, popping or clicking sensation, finger stiffness, and a tender lump at the base of the finger, as described in the context of tendinopathy 1. The symptoms of trigger finger can be attributed to the inflammation and thickening of the tendon sheath, which restricts the tendon's movement, and can result from repetitive activities, certain medical conditions, or may occur without a clear cause. Some key points to consider in the diagnosis and treatment of trigger finger include:
- A thorough physical examination, including inspection, range-of-motion testing, palpation, and examination maneuvers that simulate tendon loading and reproduce pain, as outlined in 1.
- The use of imaging studies, such as plain radiography, ultrasonography, and magnetic resonance imaging, to help confirm the diagnosis if it remains unclear, as discussed in 1.
- Treatment options, including relative rest, icing, eccentric strengthening exercises, and topical or systemic nonsteroidal anti-inflammatory drugs for acute pain relief, as recommended in 1.
- It is essential to seek medical attention if symptoms worsen or interfere with daily activities, as trigger finger can be a debilitating condition if left untreated, and early intervention can improve outcomes, as implied by the discussion of tendinopathy treatment in 1.
From the Research
Trigger Finger Symptoms
- Trigger finger is a common finger ailment, thought to be caused by inflammation and subsequent narrowing of the A1 pulley, which causes pain, clicking, catching, and loss of motion of the affected finger 2.
- The symptoms of trigger finger include clicking or locking of the finger, and other pathological processes such as fracture, tumor, or other traumatic soft tissue injuries must be excluded 2.
- Trigger fingers are common tendinopathies representing a stenosing flexor tenosynovitis of the fingers, and can be treated nonsurgically using activity modification, splinting, and/or corticosteroid injections 3.
Demographics and Risk Factors
- Trigger finger can occur in anyone, but it is seen more frequently in the diabetic population and in women, typically in the fifth to sixth decade of life 2.
- Women are affected by trigger digits more often than men and at a younger age, with an average age of 58.3 years compared to 62.1 years for men 4.
- Diabetes is a significant risk factor, with 22.1% of patients with trigger digits being diabetic 4.
Treatment Options
- Treatment modalities, including splinting, corticosteroid injection, or surgical release, are very effective and are tailored to the severity and duration of symptoms 2.
- Corticosteroid injection is the mainstay of nonoperative treatment for trigger finger, and the optimal dosage of corticosteroid injection is still being studied, with a 20-mg dose of triamcinolone acetonide found to have a significantly higher rate of clinical effectiveness at 6-month follow-up 5.
- The choice of corticosteroid can significantly affect clinical outcome, with triamcinolone demonstrating a higher rate of additional injections compared to dexamethasone and methylprednisolone 6.