Sticky Fingers

Posted by Dr. Podesta on March 17, 2011 with 4,052 Comments

After a long gig or practice session have you ever experienced pain in one or more fingers or lost the ability to bend or straighten a finger? If so, you could be experiencing what’s known as trigger finger or when it occurs in the thumb, trigger thumb. Trigger finger or stenosing tenosynovitis is a condition in which one of our fingers or thumb catches in a bent position. The finger or thumb may straighten with a snap, like a trigger being pulled and released.

Trigger finger results from a narrowing of the sheath that surrounds the tendon in the affected finger and is often quite painful. Tendons are the fibrous bands of issue that connect muscles to bone. Each tendon is surrounded by a protective sheath, which in turn is lined with a substance called tenosynovium. The tenosynovium releases lubricating fluid that allows the tendon to glide smoothly within its protective sheath as we bend and straighten our finger.

If the tenosynovium becomes inflamed from a repetitive strain injury or overuse or due to inflammatory conditions, the space within the tendon sheath can become narrow and constricting. The tendon can’t glide through the sheath easily, resulting in catching the finger in a bent position before popping straight. With each catch, the tendon becomes more irritated and inflamed, worsening the problem. With prolonged inflammation, scarring and thickening can occur and bumps or nodules can develop.

Trigger finger can result from repetitious gripping for extended periods of time, certain medical conditions, including diabetes. Trigger finger is also more common in women than in men.

Symptoms of trigger finger may first present when the affected finger stiffens and may click when you bend or straighten. A painful bump or nodule may develop at the base of the affected finger in your palm and is the spot where the tendon is likely catching. As the problem worsens, your finger may catch at times in a bent position and then suddenly pop straight. Eventually, the finger may not fully straighten.

Trigger finger more commonly occurs in your dominant hand, and most often affects your thumb, middle or ring fingers. More than one finger may be affected at a time, and both hands might be involved. Triggering is more pronounced in the morning, while grasping an object or when straightening your finger.

Treatment varies depending on its severity and duration. Mild cases can be treated with rest, splinting the finger, using nonsteroidal anti-inflammatory medication (NSAIDs), performing finger exercises, avoiding repetitive gripping, message or soaking in ice water.

Treatment of more serious cases can include NSAIDs, an injection of a steroid medication into the tendon sheath or surgical release of the tendon may be necessary for recalcitrant locking that doesn’t respond to other treatments.

The repetitive prolonged gripping that we perform as drummers on a daily basis and take for granted, can subject us to a number of soft tissue injuries. We need to take care of our hands and seek medical care with the first signs of trouble.

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