How Common is Trigger Finger?

Carpal Tunnel Syndrome (CTS) is the most widely recognized form of Repetitive Strain Injury (RSI), but Trigger Finger is catching up fast, becoming all too common among society and affecting the youth and elderly in ever-increasing numbers. If the rising numbers keep on track, Trigger Finger may be recognized along with Carpal Tunnel Syndrome as having achieved epidemic proportions.

Trigger Finger On The Rise

Prior to the 1990’s, Trigger Finger seemed to affect a small number of the elderly that had experienced some form of direct trauma or excessive strain to one or possibly several fingers. Trigger Finger was more prevalent in those that were already suffering with Osteoarthritis in the affected hand, making many healthcare professionals to believe that Trigger Finger was a byproduct of Osteoarthritis. But within the past 5-years, the age of those suffering from Trigger Finger became much “younger” while the overall number of individuals with the disorder increased. The belief of a direct correlation between those suffering with Osteoarthritis and Trigger Finger seems to be reducing in popularity as many of those suffering with Trigger Finger do not have Osteoarthritis, but instead, are involved in high-risk tasks that are already associated as the causative factor in many types of Repetitive Strain Injuries.

Injuries resulting from repeated motion (repetitive / cumulative trauma disorders — CTD’s) are growing. According to recent annual statistics from the U.S. Survey of Occupational Injuries and Illnesses, over 302,000 CTD’s account for nearly two-thirds all of workplace-related illnesses.

Ergonomic disorders are the fastest growing category of work-related illness. According to the most recent statistics from the U.S. Bureau of Labor Statistics, they account for 56 percent of illnesses reported to the Occupational Safety and Health Administration.

Trigger Finger – Recognized as a Repetitive Strain Injury

Now that Trigger Finger is rearing its head in the workplace with increased intensity, it has been added to the growing list of debilitating Repetitive strain Injuries. Trigger Finger now joins the ranks of Tendonitis, Carpal Tunnel Syndrome, Epicondylitis, Cubital Tunnel Syndrome, DeQuervain’s and the many other debilitating workplace disorders affecting the upper extremity. So, what is Trigger Finger, how is it recognized and what are its symptoms?

Trigger Finger Explained

Trigger Finger is a form of overuse injury affecting any of the fingers (1-5) with symptoms ranging from a painless annoyance with occasional snapping/jerking of the finger(s), to severe dysfunction and pain with continuous locking of the finger(s) in a flexed downward / forward position into the palm of the hand.

The occurrence of this injury usually results from overuse of the flexor muscles/tendons and the formation of an adhesion or fibrotic nodule on the tendon. If left untreated, the adhesion/nodule becomes larger, therefore creating a conflicting ratio between the size of the tendon and the size of the entrance of the tendon sheath. In most cases, if the adhesion/nodule is not treated, it can continue to increase in size (Depending on activity/use of the affected finger) to the point where it still has the ability to pass into and through the tendon sheath when flexing the finger, but becomes stuck and cannot move back through the tendon sheath when trying to extend/straighten the finger, thus causing the finger to lock in the flexed forward / downward position.

The Trigger Finger Solution

Because Trigger Finger consists of an adhesion, nodule, and scar tissue buildup on the tendon due to excess strain, overuse, or direct trauma to that specific location on the tendon, it should be treated with stretching and strengthening exercises in order to break down the adhesion on the affected tendon. By breaking down the adhesion on the affected tendon, it reduces in size and slides through the pulley system in a normal manner, no longer “catching” and locking into the downward flexed position. (There is also a “thinning” of the tendon, which helps reduce the overall size of the tendon and nodule, therefore allowing it to pass through the tendon sheath with greater ease.) Creating strength in the opposing finger extensor tendons is very important as it allows the finger to return to an extended position in a more appropriate manner. This is where muscle balancing comes into play. By creating equality of tendon length and strength on both sides of the finger joint, individuals can help prevent the onset of Trigger Finger and/or keep it from re-occurring in the future.

Conservative therapy utilizing stretches and exercises has been highly effective, providing long-term and permanent relief. For those wanting to avoid surgery and for those where surgery was not effective in eliminating the condition, stretch and exercise therapy is the solution to both preventing and rehabilitating the devastating symptoms associated with Trigger finger.

Article by Jeff P. Anliker, LMT, a Therapist and Inventor of Therapeutic Exercise Products that are utilized by Corporations, Consumers and Medical Facilities around the world for the prevention and rehabilitation of repetitive strain injuries: repetitive-strain.com.

Randy Rasa

Randy is an engineer/programmer/web designer who has suffered from repetitive strain injury off and on for over a decade.

7 Comments:

  1. Very thoughtful article. Additionally, according to Travell & Simons, while the finger is in the locked position, flex it a little more into closed position, and then apply active resistance to create even more tension on the tendon. Then gradually let the finger extend (open) while maintaining the tension.

    Massage or pressure in the tender spot where the tendon is “locked” can also help restore normal function and movement.

    And, if someone frequently grips something for a long period–such as when rowing or skiing–he or she should learn to relax their grip frequently and to stretch their hand in the opposite direction often.

    Conservative therapy utilizing stretches and exercises is an absolutely wonderful option for those wanting to avoid surgery. I’m thinking that should be all of us. 🙂

  2. A cortisone injection directly at the tendon root can be very effective very quickly. The medicine reduces the inflammation of the tendon thus allowing it to pass freely through the tendon sheath. Keep in mind that the injection must reach the affected area or there will be no effect. You may need a second shot if the first one doesn’t do the trick but getting the drug to the right spot is almost a guaranteed “cure” for this round of triggerlock. It’s also very important to identify the cause. I got a painful triggerlock from overusing power tools to build a deck. Thankfully, a single shot of cortisone fixed the problem in a day or two. I know now that whenever I use powertools to the extent I did before, I need to rest now and then and do some stretching exercises of the fingers. I just love simple solutions to complicated problems!

  3. I am a new massage therapist and after completing school and working as a massage therapist doing deep tissue massage, I have developed trigger finger in both ring fingers and tendinitis in my thumbs. I am going to see a hand MD to evaluate and get injections because this is the least invasive treatment.

    I have a few questions:

    1. Is there much swelling after injections.
    2. I work 32 hours a week and is there much swelling
    3. How long should one wait before resuming work
    4. Are there any gloves that I can wear when not working
    to reduce movements and who sells them
    5. Can hand massage assist if reducing symptoms and can you
    point me to massage techniques?
    6. What exercises should I be doing and can you advise me
    here????

    Thanks for your help!

    Jim Neugass

  4. Question to John Coleman – what City are you in? I need a Dr. familiar with this injury in Vancouver Canada.

  5. HI Jim,

    You won’t have to experience any loss of work. The shot may take a few days to kick in, but I have had tremendous luck with cortisone over my lifetime. I like the fact that this website talks about exercises to help the fingers. No one has told me that before. There is no swelling of the fingers. Just a soreness that will go away in a day. Good luck to you!

  6. Yeah i think surgery can be avoided, if you follow basic rules.

  7. I had cts surgery on my right wrist, followed by (both)trigger thumb surgeries, and a middle finger release, as well. Now all my fingers are locking and popping, but I don’t want any more surgeries if I can help it.

    I have started to use wrist braces at night to keep both the wrists in a neutral position and resting, and use small, soft vinyl balls for therapy during the day. The wrist braces are working the best for the fingers, and they help the numbness and tingling from CTS in the hand that hasn’t had the CTS surgery.

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