Dear Medical Solutions,

I am 55 years old and have never had a problem with my hands. Last month I noticed my right index finger stiffening up and it has gotten worse. I am unable to straighten it up without using my left hand. My doctor said that this is trigger finger, but I am still not sure of what this means and what to do about it. Can you help?

Answer:
Trigger finger is a painful condition that cause the fingers to lock in a bent position. The problems often stem from inflammation of tendons. The affected tendons are tough, fibrous bands of tissue that connect the muscles of the
forearm to your finger bones. Together, the tendons and muscles allow you to bend and extend your fingers and thumb, for example, as in making a fist. A tendon usually glides easily through the tissue that covers it (also called a sheath) because of a lubricating membrane surrounding the joint called the synovium. Occasionally a tendon may become inflamed and swollen. When this happens, bending the finger or thumb may pull the inflamed portion through a narrowed tendon sheath, making it snap or pop. Trigger finger may be caused by highly repetitive or forceful use of the finger and thumb. Medical conditions that cause changes in tissues — such as rheumatoid arthritis, gout or diabetes — also may result in trigger finger. Prolonged, strenuous grasping, such as with power tools, may aggravate the condition.

Some protocols we may recommend in our office for patients with trigger fingers can include limiting activities that aggravate the condition, splinting, anti-inflammatory medication, muscular and joint mobilization, and Guasha. We often times instruct the patient to perform cross friction massage of the flexor tendons at home to speed up the healing process.

If caught at the right stage, conservative chiropractic and orthopedic rehabilitation usually work well, but in advanced cases, surgery may be necessary.