trigger finger is very common and very painful. the person will notice that the finger gets stuck
in a bent position. it's usually the ring finger but can also affect the thumb
and the middle finger. the finger will catch as it bends and when trying to strengthen
it will pop and snap and hurt. today, i will answer questions about how to avoid
trigger fingers and how to treat this condition. so let's talk about trigger finger today.
before i continue let me remind you that this video is not intended
for to replace medical advice. it is for educational purposes only.
if you need medical advice contact your doctor. in case of emergency go to the nearest emergency
department or call 9-1-1. trigger finger is more common in people with diabetes,
rheumatoid arthritis, and professionals that do a lot of finger movements.
the technical name is stenosis tenocynovitis of the flexor tendons. the tendons are made of long
collagen fibers and they connect the muscles in the forearm to the bones. if we want to bend the
finger we send an order to the muscle. the muscle will shorten, pull the tendon bending the fingers
and there are many tendons in the palm of the hand. to bend the fingers many tendons on the
back of the hand. to strengthen the fingers to keep these tendons in place we have this pulleys.
many of them. so the tendons glide up and down passing through these various pulleys.
when there are repetitive movements of bending and strengthening. bending and strengthening. there
will be like a a callus formation, a thickening of the tendon due to the friction under the pulley.
the more the finger bends and straightens the pulley will get more and more inflamed.
inflammation means swelling, pain, hot, and red. then this callus in the tendon will get stuck
the person will try to strengthen the finger and will cause more damage. then, it will hurt a lot.
the best treatment is to stop bending the finger as soon as the problem starts
to avoid more thickening of the tendon and inflammation of the pulley.
we do this by immobilizing the finger at night. i recommend a night splint in some cases the person
will also need to wear them during the day. these are some examples of splints that i recommend.
there are links in the description of this video below if you want to purchase them.
i also recommend the person to apply a topical cream containing anti-inflammatory like diclofenac,
or if they don't like using a topical cream in the hand they can take tablets of nsaids like
ibuprofen or celecoxib. i have another video about nsaids that i explain their maximum
doses, the side effects, and the contraindications, and how many milligrams the person needs to take
per day. another thing that the person can do is to apply ice to reduce the pain and swelling.
they can palpate the thickened area of the tendon and this is generally where the maximum pain is.
the ice needs to be applied for at least 15 minutes. they can also self massage to try to
relieve the inflammation in the pulley. and all of these measures need to be used for about six weeks.
that is how long tendons and pulleys may take to reduce the inflammation and heal. be mindful
that the callus in the tendon may not disappear completely, so this trigger finger may come back
in the future. if all of these measures do not work then i recommend a local injection of steroids to
reduce inflammation and pain. we can do a maximum of three injections. and if these injections do
not alleviate the symptoms then i refer the patient to a hand surgeon. usually an orthopedic
surgeon or plastic surgeon. they will cut the pulley open and release the tendon. of course
this is not ideal because the tendon will be loose and could catch onto other structures. also there
is the risk that the scar tissue after the surgery will make the situation even worse
than before. but for many people the pain and the finger catch will not be a problem anymore after
the surgery. a person that had a trigger finger will need to modify their activities like the
type of work they do or to use tools that do not require too much bending of their fingers.
for people with diabetes and thyroid problem they need to control their blood sugars if they're high
or the thyroid function. if the thyroid is too low or too high because they will not
respond well to the hand treatments until they control their diabetes or the thyroid hormones.
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