Recently, a few of my patients have experienced the problem of one of their fingers seemingly stuck then suddenly… unstuck. What’s going on?
Trigger finger is a condition where your fingers seem stuck when bending or straightening and then suddenly releases and pops back. It is commonly called “trigger finger” because of the similarity to pulling the trigger of a gun. It can involve any finger including the thumb, and may affect more than one finger or more than one hand at a time. The ring finger is the most commonly affected.
Initially, people with trigger finger usually notice soreness at the base of the finger or thumb. Some people report the problem started with a painless clicking when moving the fingers. Finger stiffness is often experienced, especially in the morning, and may occur when firmly grasping an object or when straightening the finger. There may be difficulty in fully straightening or bending the finger. As the condition gets worse, the finger locks in a bent or straight position and often needs to be aided with the other hand. People will commonly say that they feel a painful clicking or popping when bending or straightening the finger. This sensation of the finger getting stuck is worse when not moving for a prolonged period of time but seems to be better with movement. Some people notice a bump at the base of the affected finger. Eventually the finger will not be able to fully bend or straighten and is usually stuck in a contracted position. Over time, due to avoiding the painful triggering, there may be the development of secondary contractures and generalized finger stiffness. Symptoms may be aggravated by hand use at work, home, gardening, and playing sports.
This condition occurs due to irritation of the tendon sheath of the finger. Tendons attach muscle to bone. The muscles that control the movements of the fingers and thumb are located in the forearm above the wrist. These tendons travel from the forearm through the wrist to the small bones of the fingers and thumb. Each tendon is surrounded by a protective tendon sheath and there is a pulley system that keeps the tendon in place next to the bones. When you bend or straighten your finger, the tendon slides through the tendon sheath and pulleys. Due to some reasons such as overuse or injury, the tendons can become irritated and thicken, forming nodules that make its passage through the pulley tunnels more difficult leading to a clicking sensation. When the tendon becomes momentarily stuck at the opening of the tendon sheath tunnel, when you are trying to bend or straighten your finger, then suddenly slips through the tight area is when you may feel a pop and the finger will suddenly shoot straight out or bend. Usually the fingers are stuck in a bent position because the tendons of the finger that control bending are strong enough to overcome the restrictive and narrowed tendon sheath while the tendons that control straightening are not.
Trigger finger reportedly happens more to people whose work or hobbies require repeated and strong gripping actions such as farmers, industrial workers, and musicians. However, studies have not found any definite association between trigger finger and the workplace, so the cause is probably due to multiple factors. The condition tends to be found more in women and those between the ages of 40 to 60. It is more common in individuals who have diabetes, rheumatoid arthritis, renal disease, hypothyroidism, amyloidosis, etc. It may be a complication associated with surgery for carpal tunnel syndrome. Sometimes it can happen after a hand injury. In many cases the condition has no known cause and is insidious.
Trigger finger can be diagnosed with a physical exam of the hand and fingers. Lab tests and x-rays are usually not necessary unless ruling out other differential diagnoses. If you notice that there is stiffness, catching, numbness, or pain in a finger joint or you are unable to straighten or bend a finger then make an appointment with a health professional. You may notice that the finger is swollen or there is a bump over the joint. For self-care at home you may try resting, applying heat, applying ice, stretching, and modifying your activities that involve repeated gripping. Chiropractors may manage this problem with modalities such as ultrasound and/or electric stimulation, Graston, wax therapy, rehabilitation exercises, adjustments, splinting, etc. For chiropractic therapy, the goal is to decrease the swelling and get rid of the locking to allow full, painless movement of the fingers. If these conservative measures don’t work then surgery may need to be considered where the pulley at the base of the finger is cut open to allow the tendon to glide more freely.
7 Exercises to Try for Trigger Finger:
- Lay your palm down on a flat surface. Lift each finger one by one and hold in the lifted position for 2 seconds before returning to the original position. You may use your other hand to pull the fingers to increase the tension. Repeat 10 times each finger.
- Wrap a rubber band around your fingers. Open and close hand against the resistance. Repeat 20 times each hand.
- Touch each finger to your thumb. Repeat for 2 minutes.
- Hold a therapy ball in your palm. Squeeze for 5 seconds then release. Repeat 10 times.
- Fold your fingers down together joint by joint until you make a fist, then straighten your fingers. Repeat 20 times.
- Massage the joint and area affected by the trigger finger for 3 minutes.
- Place a towel on a table. Place your palm on the towel. Grab the towel with your fingers and scrunch it while applying pressure on your fist. Maintain this position for 5 seconds then straighten fingers slowly. Repeat 15 times.