This is for you… Hand Therapists!
Stenosing tenosynovitis, otherwise known as trigger finger, is a common condition affecting children and adults of all ages.
- Trigger finger usually occurs at the A1 pulley
- It occurs with inflammation of the tendons and sheaths of fds and fdp
- The digit can lock in both flexion and extension… That’s right I said extension
- The risk for trigger finger is between 2-3% in the population and 10% in diabetics
- It can be associated with metabolic disorders such as osteoarthritis, rheumatoid arthritis, collagen disease and carpal tunnel syndrome
Trigger Finger Treatment How-To
There are three basic option for trigger finger treatment … as long as we are not talking about the THUMB
- Injection 60-65%
- Therapy (splinting) 60-65%
- Therapy (splinting) and injection together 80%
- Surgery almost always, around 98% of course there are complication and the risk of anesthesia.
What Type of Splint Should You Use?
Any type of immobilization that limits the triggering will suffice. It could be a splint to immobilize the DIP, PIP or MCP. My personal favorite is an oval eight at the pip joint. I typically recommend wearing the splint for 3 weeks all of the time, than an additional 3 weeks night-time only, for a total of 6 weeks.
What About Trigger Thumb?
The triggering thumb typically does not resolve with conservative measures. Often times people with trigger thumb will need surgical intervention to resolve their symptoms.
What About the Doctor Who Does Not Believe in Splinting?
A lot of times physicians will tell you splinting doesn’t work. However, the research says otherwise! I often tell doctors there is no harm in trying therapy, it has very low risks and as therapist, we often are teaching our patients many more things that encourage good hand health! So I say why not!!
More To Read
Woo Hong, S. Kim, J., Sang Kwon, O., Ho Lee, M., Sik Gong, H., Hyun Baek, G., (2019). Radiographic Remodeling of the Proximal Phalangeal Head Using a Stretching Exercise in Patients With Camptodactyly. J Hand Surg Am, 1.e1-1.e10 The Skinny – Camptodactyly is a congenital, nontraumatic flexion contracture of the PIP in fingers other than…Read More
Rapid Review. Outcomes of pediatric and adolescent carpal tunnel release based on etiology. Velicki, K., Goldfarb, C. A., Roberts, S., & Wall, L. B. (2021). Outcomes of pediatric and adolescent carpal tunnel release. The Journal of Hand Surgery, 46(3), 178-186. The Skinny: Less than 1% of pediatric carpal tunnel is idiopathic in nature, compared to…Read More
By: Dalton Busch Below I have created a list of some of the common assessments that are seen in the hand therapy world. Keep in mind that this list is not inclusive of all the assessments you might come across in this setting. With each assessment, I describe what it is, who the assessment is…Read More
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