Commonly known as “Trigger finger, or Stenosing Tenosynovitis, involves the pulleys and tendons in the hand that bend the fingers. The tendons work like long ropes connecting the muscles of the forearm with the bones of the fingers and thumb. In the finger, the pulleys are a series of rings that form a tunnel through which the tendons must glide. Trigger finger/thumb occurs when the pulley at the base of the finger becomes too thick and constricting around the tendon, making it hard for the tendon to move freely through the pulley. Sometimes the tendon develops a nodule (knot) or swelling of its lining. Because of the increased resistance to the gliding of the tendon through the pulley, one may feel pain, popping, or a catching feeling in the finger or thumb.
The cause for trigger finger is still unclear in many cases. Some trigger fingers are associated with medical conditions such as rheumatoid arthritis, gout, and diabetes. Local trauma to the palm/base of the finger may be a factor on occasion, but in most cases there is not a clear cause.
Treatment goal of trigger finger is to present locking and allow full motion in the finger/thumb. The first line of treatment is a steroid injection into the tendon sheath to decrease swelling and allow the tendon to glide through the pulley. If steroid injection fails, Dr. Goldberg will recommend surgical release of the pulley at the base of the finger.