Trigger Finger Classification

The term trigger finger describes a condition in the hand that causes clicking in one or more fingers when they are bending. Trigger finger is caused by a thickening or nodule that forms on the flexor tendon in the palm. These tendons glide through narrow tubes called sheaths, and clicking occurs as the nodule catches on the opening of this sheath. Trigger finger is classified by the level of severity, and treatment varies at each level.

Causes and Prevention

• Inflammation of the flexor tendon sheath, which can lead to trigger finger, is associated with different risk factors. Repetitive or prolonged gripping is the most common cause. People who work with power tools, play musical instruments or work on the computer for extended periods are at risk for the development of trigger finger. Some systemic illnesses, like diabetes or rheumatoid arthritis, can increase the risk of trigger finger as well. Trigger finger is not always preventable; however, there are things that can be done to reduce the risk of its development. Take a break every hour during gripping activities to stretch your hands and forearms. This will reduce the amount of continuous strain on the flexor tendons. Use gloves that are padded in the palm when operating power tools or tools that vibrate.

Mild or Acute Trigger Finger

• Mild or early cases of trigger finger are characterized by pain in the palm where the large knuckles bend. Pain may occur at rest, as well as during gripping or finger-bending activities. Mild trigger finger is treated with rest from aggravating activities, splinting to prevent the large knuckle of the involved finger(s) from bending, heat or cold application to decrease pain and swelling, and possibly physical therapy intervention.

Moderate Trigger Finger

• Moderate cases of trigger finger are characterized by a clicking or catching sensation that occurs when the finger is moved from the bent position to straight. This sensation is accompanied by pain in the palm. You may also feel a nodule or thickening when you press on the area that is painful. This level of tendon involvement is treated with the same interventions as mild cases, but may also require an injection of cortisone into the flexor tendon sheath or oral anti-inflammatories to decrease inflammation.

Severe Trigger Finger

• Severe trigger finger is characterized by a finger that gets stuck in a bent position and must be manually brought back into a straight position using the opposite hand. Sometimes the finger cannot be returned to a straight position. People with severe trigger finger should immediately see an orthopedic surgeon to prevent a permanent joint contracture from developing. Surgical intervention for trigger finger involves the release of the tendon sheath to make room for the nodule to pass as the finger is bent.