Trigger Fingers and Hand Pain

A lot has been written in news articles and social media about grip strength and longevity. I feel that it's important to talk about an unfortunate side effect of the tight narrow grip, which is a trigger finger.

1) What is trigger finger?

Patients commonly see me for symptoms that their fingers "lock-up" and get stuck in flexed position (I usually see 2-5 patients with this each time I'm in the office). Sometimes the only way they can straighten their finger again is to use their other hand to physically pry the finger open. This is a classic trigger finger, and it can be frustrating and painful.

Trigger finger is a type of tendonitis that affects the tendons that allow us to flex our fingers into a fist. Just like any other tendonitis, it can be brought on by overuse, inflammation, and sometimes an acute injury.

While most patients who see me for this condition come in with classic symptoms, some just have pain in this side of the hand, over the tendon and in the palm - there is a structure in this area called the A1 pulley which functions to keep the tendon close to the bone and move efficiently to flex the finger. In trigger finger - this area can be a spot of friction and cause the tendon to get stuck.

2) How do you treat it?

As long as it's safe for you to take NSAIDS like Advil, Motrin, Ibuprofen, or Naproxen, and the symptoms have only been going on for three weeks or less, you can take these medication's around the clock for a few days (within safe dosage limits) and see if symptoms will subside. In this period of time, you should avoid tight, narrow gripping of the hand, which seems to aggravate the issues.

If the symptoms persist beyond the first 3-6 weeks, we will typically offer a Cortisone shot or a steroid injection in the office. This works in about 50% of patients. It may cure the problem or at least provide symptom relief which can last for more than a year.

Surgery can be very effective and is done under local anesthetic (like at the dentist), and works almost universally to relieve the triggering symptoms, however, the pain and swelling in the area can persist for several months after surgery as we are not treating the information directly, your body will have to overcome information on its own. What surgery does is relieves the sticking point on the tendon to allow better gliding so that your body has an opportunity to reduce the inflammation and pain on its own.

3) Can I prevent this from happening?

There are a few ways to reduce the risk of developing a trigger finger. The first is to wear protective gloves when you're performing activities, such as raking in the garden or other work that requires a tight, narrow grip.

If you are weight lifting as part of your exercise,I always advocate the use of weightlifting gloves or straps to minimize the amount of strain your hands experience during these sessions to help prevent trigger finger symptoms.

Diabetes is associated with developing a trigger finger, so keeping your blood sugars under control can also be very helpful in reducing the risk.

As someone who's personally experienced triggers symptoms, both from weightlifting, and from prolonged driving, I can empathize with how uncomfortable these symptoms are. I am hopeful that you'll take my advice for prevention, and know that if you do start to develop symptoms that there are certainly several things that we can do to help your hands feel better.