Trigger finger

Do you have trouble with your fingers locking or not being able to smoothly straighten them? You could be suffering from trigger finger. In this post I’ll discuss what the causes may be and how to go about treating it.

What is trigger finger and what causes it?

Trigger finger is where your finger gets either locked in the bent position or cannot smoothly straighten itself from a bent position. It can either be painless or for some can be painful.

It is often caused by repetitive overuse of the hand and its fingers or from your hand/fingers being locked in the same position for an extended period of time. Activities that can cause this include, using the computer mouse a lot, playing an instrument like a guitar for example, from work that requires hard manual labour, or sports that require holding a bat for a long time, such as tennis or yes even lifting weights where you have to hold barbells and dumbbells for long periods of time. People with arthritis or diabetes are also more prone to suffer from it.

The reason trigger finger may occur during these activities, is down to the tendons in your finger/palm becoming inflamed and are then unable to glide smoothly through its surrounding sheath. This causes the finger to get stuck when you try to straighten it. If the inflammation is just enough to cause a small swelling the locking can be just enough to temporarily stop the finger straightening and if it can get past the sticking point will then snap past the sticking point, popping to the straight position. While more severe cases can also have a narrowing of the sheath itself, caused by scaring and thickening of the sheath, making it worse and often locking your fingers completely.

Often trigger finger can be/feel worse in the morning, due to non activity during your sleep period.

How to treat trigger finger

Early treatment is highly recommended to avoid having to have surgery, as leaving it can cause the inflammation to harden and become less treatable with home remedies. Home treatment can sort it out if done soon enough and on a regular basis, so don’t ignore the situation.

Firstly:

• If possible stop doing any activities that either caused the issue or makes the fingers worse. If you can’t get away from the use of your affected finger/fingers, make sure you rest it often and apply some of the techniques below.
• Use ice to reduce any inflammation if it is a new occurrence. Use warm water or a hand warmer 24 hours after to increase blood flow to the area.
• Use an anti-inflammatory and pain relief such as ibuprofen.
• If lifting weights, use of gloves and/or straps can often help either before a problem occurs or to reduce your current symptoms. But avoid any exercise that has you gripping a heavy weight or handle for an extended period of time until you are fully recovered.
• If you use a computer a lot, take regular rests and replace the mouse with a more ergonomic type. Try using a vertical mouse, rollerball/trackball mouse or even a touch pad. Same goes for those who play games consoles a lot, make sure you rest and stretch your hands regularly.
• If needed, use a finger splint between treatments or to reduce overuse of the affected tendon. But only wear these when necessary.

Do this routine once in the morning and once in the evening:

1. We are going to start with the forearm because your forearms are closely connected to the function of your hand. Gently massage the wrist and forearms. Use a massage tool if needed. This can help reduce stress to the hand and its connected tendons and increase blood flow to the muscles.
2. Stretch the muscles of the forearm and wrist tendons by holding out your arm in front of you and bending your hand up at the wrist. Then very gently pull back on your fingers with your other hand. Hold for 5-10 seconds and repeat 3-5 times. Now do the same with your hand pointing down. Make sure you lock the elbows out to get a good stretch in the forearm. Be very gentle doing this, just enough pressure to feel a small stretch.  You can also try doing the prayer wrist stretch, where you hold your hands together in the praying position and gently press together while bringing your elbows out and your wrists towards your body.
3. Gently massage using your thumb or a soft massage tool the effected finger and most importantly massage around the tendons of the palm connecting the affected finger to your hand. Massage in all directions. This helps to increase blood flow, reduce tension and warm-up the affected area.
4. Now do some traction pulls. To do a traction pull, grab a finger and while using moderate pressure pull on the finger. This helps realign and relieve pressure around the tendons and muscles of the finger. Do this 2-3 times.
5. Do finger abduction stretches by placing two fingers of your other hand between your affected finger and the finger next to it to create a V shape. Do this on both sides of the affected finger one after the other. Hold for 5 seconds and release. Repeat 5 times.
6. Do finger extensor stretches. Place your hand down on a table and with your other hand pull up your finger and stretch the finger upwards and hold for 5 seconds and release. Repeat 5 times.
7. Do isometric/static squeezing or hard object squeezing to strengthen the hand (look these up on the internet for best description/demo of the appropriate exercises). But generally you can squeeze something like a tennis ball to help strengthen the muscles of the hand. Note that these are generally best done for recovery and only done if you have no pain.
8. Do exercises to also strengthen the muscle of the back of the hand. This can be done by placing a rubber band around all your fingers and then opening the fingers out against the resistance of the bands. You can also do what I call table finger lifts. Place your hand palm down on a table and lift each finger individually off the table, holding each one up for 5-10 seconds.
9. Do finger flexion and extension exercises, such as knuckle bends (there are many types you can do, so look these up on the internet for the best description/demo).
10. Do tendon gliding exercises (again look this up on the internet for best description/demo).
11. Once again return to one of the most important parts of treating trigger finger. That is to do some proper massaging along the tendon and the tendon nodule of the affected finger/fingers. Here you want to use a hand massage tool such as a Myofascial release scraping tool. You want to rub/scrap and massage the tendon and surrounding area in all directions, pushing gently to start with and then with increasing pressure as comfortable. This is to help break up scar tissue that maybe causing the finger to get stuck.
12. Finally use heat to increase blood low to the hand. This aids recovery by letting the blood deliver nutrients to the area and remove waste, which both help in the healing process. Heat can be applied before and after the above exercises.

Doing the above early enough can often help heal trigger finger within 4-8 weeks. However for severe cases, you should see your doctor, who may either have to give you corticosteroid injections or possibly recommend surgery. In any case when doing any of the above, only do what is comfortable and stop doing anything that you feel may being making the injury worse and seek medical advice. Also if you can’t do all the exercise in one go, split them up and do them throughout the day.