From the Research
Yes, trigger finger can involve the proximal interphalangeal (PIP) joint, although it more commonly affects the metacarpophalangeal (MCP) joint. This condition, also known as stenosing tenosynovitis, occurs when inflammation narrows the space within the tendon sheath, causing the tendon to catch or lock during finger movement. When it affects the PIP joint, patients may experience catching, locking, or painful clicking at this middle joint of the finger.
Treatment Options
Treatment options include:
- Rest
- Splinting, with studies showing that a custom-made orthosis can be effective in treating trigger finger, even when it involves the PIP joint 1
- Anti-inflammatory medications like ibuprofen (400-800mg three times daily with food)
- Corticosteroid injections into the tendon sheath
- In persistent cases, surgical release, such as resection of the flexor digitorum superficialis for patients with a positional contracture of the PIP joint 2 The underlying mechanism involves thickening of the A3 pulley (which overlies the PIP joint) or the tendon itself, creating mechanical interference with smooth tendon gliding. This differs from the more common A1 pulley involvement at the MCP joint but produces similar symptoms.
Key Considerations
Early treatment is important to prevent permanent contracture or stiffness of the PIP joint, which can significantly impact hand function. Non-steroidal anti-inflammatory drugs (NSAIDs) may offer little to no benefit over glucocorticoid injection in the treatment of trigger finger, based on low- to very low-certainty evidence from two trials 3. The choice of treatment should be individualized, taking into account the patient's specific condition, medical history, and preferences.