Trigger Finger… Quick and Dirty!

This is for you… Hand Therapists!

Stenosing tenosynovitis, otherwise known as trigger finger, is a common condition affecting children and adults of all ages.

Fast Facts

  1. Trigger finger usually occurs at the A1 pulley
  2. It occurs with inflammation of the tendons and sheaths of fds and fdp
  3. The digit can lock in both flexion and extension… That’s right I said extension
  4. The risk for trigger finger is between 2-3% in the population and 10% in diabetics
  5. It can be associated with metabolic disorders such as osteoarthritis, rheumatoid arthritis, collagen disease and carpal tunnel syndrome

How is Trigger Finger Treated?

There are three basic treatment option for trigger finger… as long as we are not talking about the THUMB

  1. Injection 60-65%
  2. Therapy (splinting) 60-65%
  3. Therapy (splinting) and injection together 80%
  4. Surgery almost always, around 98% of course there are complication and the risk of anesthesia.

What Type of Splint Should You Use?

Any type of immobilization that limits the triggering will suffice. It could be a splint to immobilize the DIP, PIP or MCP. My personal favorite is an oval eight at the pip joint. I typically recommend wearing the splint for 3 weeks all of the time, than an additional 3 weeks night-time only, for a total of 6 weeks.

What About Trigger Thumb?

The triggering thumb typically does not resolve with conservative measures. Often times people with trigger thumb will need surgical intervention to resolve their symptoms.

What About the Doctor Who Does Not Believe in Splinting?

A lot of times physicians will tell you splinting doesn’t work. However, the research says otherwise! I often tell doctors there is no harm in trying therapy, it has very low risks and as therapist, we often are teaching our patients many more things that encourage good hand health! So I say why not!!

7 Comments

  1. Blake on February 1, 2021 at 5:50 am

    In the section “How is Trigger Finger Treated?” there are percentages listed next to each treatment, and I’m wondering what each percentage means?

    • Miranda Materi on February 1, 2021 at 10:53 pm

      It refers to the efficacy. Thanks for asking.

  2. Sandra on February 1, 2021 at 6:25 am

    Can you put a photo of splint: “My personal favorite is an oval eight at the pip joint.” Thanks

  3. Linda on February 1, 2021 at 8:24 am

    I am a retired pediatric OT and experienced triggering in the DIP of my right thumb, dominant hand, mid-December. After one week of self-care, which was mainly rest and massage, I went to see a CHT. Her evaluation, treatment and home program of exercises was very helpful. I do the exercises every day. Now, about one month later, the “click” and triggering is almost gone, but I continue with the exercises and massage to maintain ROM and circulation. Some stiffness and weakness remains, especially in colder weather.

  4. Eric Ginzburg on February 1, 2021 at 8:54 am

    Do the percentages refer to efficacy?

  5. Tatiana Catini on February 1, 2021 at 12:02 pm

    I really want to know about the references? Could you indicate the articles about this findings? Tks.

  6. Maureen kline on February 2, 2021 at 3:22 am

    Metacarpal/ phalengeal joint trigger in the digits???Have you used relative motion or yoke splint???

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