What Is Stenosing Tenosynovitis?

Stenosing tenosynovitis which is also known as trigger finger is a medical condition in which one of your fingers gets stuck in a bent position. Your finger may bend or straighten with a snap – like a trigger being pulled and released.

It occurs when inflammation narrows the space within the sheath that surrounds the tendon in the affected finger. If trigger finger is severe, the finger may become locked in a bent position.

People whose work or pursue hobbies require repetitive gripping actions and are at higher risk of developing trigger finger. The condition is also more common in women and in anyone with diabetes. Treatment of trigger finger varies depending on the ferocity.

Symptoms may progress from mild to severe which may include:

• Finger stiffness, particularly in the morning
• A popping or clicking sensation as you move your finger
• Tenderness or a bump (nodule) in the palm at the base of the affected finger
• Finger catching or locking in a bent position, which suddenly pops straight
• Finger locked in a bent position, which you are unable to straighten

Trigger finger can affect any finger, including the thumb. More than one finger may be affected at a time, and both hands might be involved. It is usually noticeable in the morning, while firmly grasping an object or when straightening your finger.  the patient should seek immediate medical care if the finger joint is hot and inflamed, as these signs may indicate infection.

If you have any stiffness, catching, numbness or pain in a finger joint, or if you can’t straighten or bend a finger, fix an appointment with a doctor.

Factors that put at risk of developing trigger finger include:

Repeated gripping–  Occupations and hobbies that involve repetitive hand use and prolonged gripping may increase the risk of trigger finger.

Certain health problems- People who have diabetes or rheumatoid arthritis are at higher risk of developing trigger finger.

Your sex– Trigger finger is more common in women.

Carpal tunnel syndrome surgery–  Trigger finger may be a complication associated with surgery for carpal tunnel syndrome surgery, especially during the first six months after surgery.

Surgical and other procedures

Steroid injection- An injection of a steroid medication near or into the tendon sheath may reduce inflammation and allow the tendon to glide freely again. This is the most common treatment, and it’s usually effective for a year or more in most people treated. But sometimes it takes more than one injection.

For people with diabetes, steroid injections tend to be less effective.

Percutaneous release- After numbing palm, the doctor inserts a sturdy needle into the tissue around the affected tendon. Moving the needle and your finger helps break apart the constriction that’s blocking the smooth motion of the tendon.

This treatment may be done under ultrasound control so the doctor can see where the tip of the needle is under the skin to be sure it opens the tendon sheath without damaging the tendon or nearby nerves. This procedure is usually done in the doctor’s office or in an office procedure room.

Surgery- Working through a small incision near the base of the affected finger, a surgeon can cut open the constricted section of tendon sheath. This procedure is usually done in an operating room.

Medications

Nonsteroidal anti-inflammatory drugs — such as ibuprofen (Advil, Motrin IB) or naproxen (Aleve) — may relieve the pain but are unlikely to relieve the swelling constricting the tendon sheath or trapping the tendon.

Therapy

Rest- Avoid activities that require repetitive gripping, repeated grasping or the prolonged use of vibrating hand-held machinery until your symptoms improve. If you can’t avoid these activities altogether, padded gloves may offer some protection.

A splint- Doctor may have you wear a splint at night to keep the affected finger in an extended position for up to six weeks. The splint helps rest the tendon.

Stretching exercises- Doctor may also suggest gentle exercises to help maintain mobility in the finger.