What is Trigger Finger and How Do You Fix It?
Grace Weatherby
/ Categories: WELLNESS, 2023

What is Trigger Finger and How Do You Fix It?

One of the most common sources of hand pain for adults, trigger finger is a condition in which one of your fingers gets stuck in a bent position. Formally called stenosing flexor tenosynovitis, it can affect any finger but most commonly occurs in the ring finger, middle finger, and thumb.

The most common symptoms of trigger finger include a bump at the base of the affected finger or thumb and associated pain when moving it or applying pressure. In addition, patients often report stiffness or clicking when moving the affected finger or thumb, particularly first thing in the morning.  If left untreated, the finger may actually get stuck in the bent position and then snap straight (the “triggering” in trigger finger). Over time, you may not be able to fully bend or straighten the finger.

As for what’s behind this troubling condition, trigger finger is the result of an inflamed tendon in the affected finger. Inflammation creates a thickening of the tendon that interferes with normal movement. Over time, nodules can form that may make bending or straightening the joint difficult.

While the reason trigger finger happens is unknown, there are a number of factors that may put you at greater risk of developing the condition. These include: 

  • Repetitive gripping: Occupations, activities, and hobbies that involve repetitive hand use and prolonged gripping may increase your risk of trigger finger.
  • Certain medical conditions: People who have diabetes, hypothyroidism, or rheumatoid arthritis are at higher risk of developing trigger finger.
  • Gender: Trigger finger is more common in women, especially those over 40.
  • Carpal tunnel syndrome surgery. Trigger finger is a recognized complication associated with carpal tunnel syndrome surgery, occurring most often during the first six months after surgery.

For some lucky individuals, trigger finger may get better without treatment. But for others, there are a number of potential treatment options. These include:

Rest: avoiding repetitive motion or gripping activities may help reduce inflammation

Medication: over-the-counter medications such as aspirin and ibuprofen can reduce inflammation

Steroid injection: a steroid injected in the soft tissue above the tendon can usually resolve trigger finger in 1-2 injections

Surgery: considered a last course of action, a simple surgical procedure lasting 5-10 minutes, can completely resolve the issue. However, it may take two to four weeks to recover and there may be some stiffness even after surgery.

If you’re experiencing symptoms of trigger finger, don’t hesitate to contact your healthcare provider. A simple cortisone injection may be all you need for the symptoms to go away.  And left untreated, it can be a source of persistent pain and can make everyday tasks or hobbies difficult.

 

David Veltre, MD, is a board-certified hand and upper extremity specialist at SVMC Orthopedics, which has offices in Bennington, VT and Williamstown, MA.

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Emergency Department: Open, Ready, Safe. 

The last 3 months have been a uniquely challenging experience in the SVMC Emergency Department (ED) and emergency departments and hospitals all over the country and the world. I am very proud of all our staff has done and continues to do to ensure safe care for patients during this era of COVID-19. We are grateful that cases of COVID-19 in our area have been the lowest in the U.S. and have decreased even further over the past several weeks. We are also heartened to see that patients who had been avoiding the ED are now confident to return to get the care they need.

It may be surprising to hear that over the past few months, the sickest patients we have seen in the ER have not had COVID-19. Many people have refrained from seeking care for serious medical problems due to the fear of being exposed to the virus, assuming that the hospital was not a safe place to be and not recognizing the seriousness of their symptoms. The most challenging moments of the past several months have involved critically ill patients who tried to stay away for far too long due to fear of being exposed to COVID-19. We have had many sad moments trying to care for those who waited until it was too late for us to help with conditions that could have been easily treated if presented sooner.

One might expect that the greatest challenges related to the pandemic were those needed to adapt our facilities and procedures and the work of caring for sick COVID-19 patients. SVMC is fortunate to have built a strong foundation of safety and infection-prevention methods over many years, which made this transition much easier. Still, when it became apparent that we were going to see COVID-19 cases coming through our doors, we implemented many COVID-specific changes very quickly.

From day one our staff have all been fully trained to use protective equipment effectively, to focus on cleaning and disinfecting, and to move patients safely through the new areas created to keep them safe. We also spaced the waiting room chairs to allow for plenty of distance and initiated drive-by testing to keep potentially contagious people outside and away from other patients.

We immediately increased our standard of protective equipment we use. For example, all staff who relate with patients now wear both a mask and protective shield, which is a proven and effective strategy to prevent transmission. Those staff who work with patients with respiratory or other contagious symptoms also wear a gown and advanced respirators developed in cooperation with Mack Molding in Arlington. They look strange, but they help us deliver care safely.

We also quickly built special spaces and units in the hospital to treat and segregate patients with respiratory symptoms who might be contagious from those with other routine medical problems. Outpatients with symptoms that could be related to COVID-19 are directed to a spacious area called the Respiratory Evaluation Center. There they can be taken to a safe treatment space called a negative-pressure room without encountering any patients who are using the ED for other reasons or any staff who are not fully equipped with protective gear. There are similar, safe, negative-pressure units for those who require treatment in the ED or hospital.

Our hard work paid off. We have treated a number of COVID-19 patients in our ED and, as far as we know, not a single staff member was sickened in relation to their work here, and no patients have contracted COVID-19 while under our care. With our current procedures and drastically declining COVID numbers, we are confident that we can continue that trend. Furthermore, SVMC recently received a perfect score on a rigorous survey specifically designed to judge our ability to prevent transmission of COVID-19. At this time our ED is safer than just about any other public place you could go.

My goal in writing today is to communicate that SVMC’s Emergency Department is open, ready, and safe. If you need emergency care, we are here and we can care for you safely. Please do not defer emergency care until it is too late for us to help. While many symptoms can represent a serious medical problem, the most concerning are chest pain, difficulty breathing, fast heart rate, confusion, high fever, intense headache, drooping face, dehydration, or weakness. Of course, with any other symptom you feel indicates a serious problem, come in right away or call 9-1-1.

For us, spending time with patients and connecting on a personal level is the best part of our jobs. We take pride in our life-saving role in our communities and the work we have been able to do during the pandemic, but we cannot help if you do not come in. Please don’t hesitate to get the care you need when you need it.

Adam Cohen, MD, is a board-certified emergency medicine physician at Southwestern Vermont Medical Center. He also serves as the chair of the Department of Emergency Medicine and the medical director of SVMC’s Emergency Department.

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