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(Stenosing Tenosynovitis; Volar Flexor Tenosynovitis)
by Nicky Lowney, MA
Tendons connect bones to muscles in the body. Flexor tendons of the thumb and fingers pull the fingers into a fist. The tendons are enclosed in a synovial sheath. When this sheath becomes inflamed it can cause trigger finger.
Usually, tendons slide easily through the sheath as the finger moves. In the case of trigger finger, the synovial sheath is swollen. The tendon cannot move easily. This causes the finger to remain in a flexed (bent) position. In mild cases, the finger may be straightened with a pop. In severe cases, the finger becomes stuck in the bent position. Usually, this condition can easily be treated.
Many cases of trigger finger are caused by:
Risk Factors TOP
Trigger finger is more common in women, and in people aged 40-60 years old. Other factors that may increase your chance of trigger finger include:
Trigger finger may cause:
You will be asked your symptoms and medical history. A physical exam will be done. The physical exam may include:
Your doctor can diagnose trigger finger based on the exam. For severe cases, your doctor may refer you to a hand specialist.
Talk with your doctor about the best plan for you. The goal of treatment is to reduce swelling and pain. This will allow the tendon to move freely in the sheath. Treatment options include the following:
Stopping movement in the finger or thumb is often the best treatment for mild cases of trigger finger. A brace or splint may be used. Rest may be combined with stretching the tendon.
Severe cases of trigger finger may not respond to medications. In this case, surgery may be used to release the tendon from a locked position. This surgery is usually performed on an outpatient basis. It only requires a small incision in the palm of the hand.
Avoid overuse of the thumb and fingers. If a job or hobby involves repetitive motions of the hand, take the following steps:
Hand Care—American Society for Surgery of the Hand
Ortho Info—American Academy of Orthopaedic Surgeons
The Arthritis Society
Salim N, Abdullah S, et al. Outcome of corticosteroid injection versus physiotherapy in the treatment of mild trigger fingers. J Hand Surg Eur Vol. 2011 Aug 4.
Trigger finger. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114490/Trigger-finger. Updated March 24, 2017. Accessed August 24, 2017.
Vance MC, Tucker JJ, et al. The association of hemoglobin a1c with the prevalence of stenosing flexor tenosynovitis. J Hand Surg Am. 2012 Sep;37(9):1765-1769.
Last reviewed August 2017 by EBSCO Medical Review Board Warren A. Bodine, DO, CAQSM
Last Updated: 9/30/2013
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