Trigger Finger and Trigger Thumb

The most common condition associated with hand and digital pain is “Stenosing Tenosynovitis,” otherwise known as a “trigger digit.” Flexor tendons course from the palm to each digit act like ropes which pull the finger down (flexion). As each flexor tendon enters the digit, there are several straps (flexor sheath pulleys), which hold the tendon near the bone and prevent bowstringing when the digits are flexed. For normal finger motion, flexor tendons must glide smoothly underneath each flexor strap or pulley. Commonly, the flexor tendons become thickened as they enter the digit and rub (or get stuck) underneath the first flexor strap. Progressive thickening of the tendon may occur and eventually the flexor tendon may be noted to click or “trigger.” Similar to Carpal Tunnel Syndrome and DeQuervain’s tendinitis, causative factors may include any condition which causes thickening or swelling of tissues. Often the cause of trigger digits is not known; however, treatment involves either shrinking the flexor tendon (cortisone injection), or enlarging the first flexor strap (surgical trigger digit release).

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