Trigger Finger: Overview

Trigger Finger: Overview

This video will provide an overview of trigger finger. Trigger finger is a mechanical problem causing catching between the tendons and pulleys in the fingers. Tendons connect muscles to bones, allowing the muscles to move the skeleton. In this condition, the tendons on the palm side of the fingers are involved. Muscles in the forearm power these tendons and are responsible for flexing or bending the fingers.

Pulleys are bands of tissue that act like belts in the finger. They wrap around these tendons to keep them close to the bone, which improves tendon efficiency. The most force travels across the pulley at the base of the finger, called the A1 pulley. This pulley is the most involved in trigger finger. The pulley becomes inflamed and enlarged, restricting the tendons' ability to glide beneath it. Over time, with mechanical squeezing through the pulley, the tendon will also thicken.

The cause of trigger finger is not entirely known, however, repetitive finger movement or trauma in this area may be to blame. Certain medical conditions may place patients at higher risk, such as diabetes, thyroid disease, and rheumatoid arthritis. The condition most commonly impacts those in their 40s to 60s, and is 6x more common in women than men. It occurs most frequently in the dominant hand.

Those with a trigger finger often report pain and a clicking sensation at the finger's base. In more advanced cases, the finger can lock in a flexed position, requiring the patient to pull it straight. A nodule may be felt at the base of the finger as the tendon thickens. The diagnosis is typically made clinically, meaning a health care provider can diagnose trigger finger based on the patient's history and examination alone. If the diagnosis is in question, an ultrasound examination can be done to look at the tendon movement through the pulley and assess for swelling.

In summary, trigger finger is a mechanical issue between the tendons and pulleys. The causes of this condition are not fully understood, but women and those with conditions like diabetes are at higher risk. Symptoms may include painful clicking or catching sensation at the finger's base. The diagnosis for this condition is made with exam and history alone, although ultrasound may be helpful.