Aug 2, 2014

Trigger Thumb

What Is Trigger Thumb?

Trigger thumb, or stenosing tenosynovitis, refers to a condition where the thumb catches in a bent position and when (if) it straightens, it does so with a pop or clicking sensation and pain. This condition is not exclusive to the thumb. It can occur for any digit of the hand, though it is most often found in the thumb or the middle and ring finger.

Thankfully, most cases of trigger thumb or trigger finger can be relieved without surgery or other invasive treatment options by simply wearing a trigger thumb splint or trigger finger brace. BraceAbility offers such quality products at affordable prices. The top-selling Active Innovations Trigger Finger Splint, for instance, comes with a price tag well below what one would pay for a date night at the movies. (Read reviews for the splint.)

To explain the causes of trigger thumb, I need to go through a quick anatomy lesson. The tendons that are responsible for moving the fingers are held in position by a series of ligaments known as pulleys that form a tunnel for the tendons to run along the bones. This archway is coated with a slick coating known as tenosynovium that enables the tendons to smoothly glide through the passage. 

trigger thumb

 

Irritation of this tenosynovium can cause inflammation that narrows the sheath through which the tendon passes. This, in turn, irritates the tendon and causes more inflammation, causing it to catch as it moves through the passageway. Repeated irritation over time can cause the tendon to thicken and scar and form a nodule or bump that can catch in the sheath and prevent the finger or thumb from straightening.

What Causes Trigger Thumb?

Trigger thumb causes are not well understood outside of the medical side of things. It is more common in women than men and it is more prominent in those over the age of 40. Trigger finger/thumb is also linked with certain conditions such as diabetes and conditions involving inflammation of the joints, like gout and rheumatoid arthritis.

Thumb trigger finger is also thought to be associated with repetitive gripping motions over an extended period, such as if one’s career or hobby involves repeated grabbing motions.

Trigger Finger in Children

The situation is different in cases of pediatric trigger thumb. As is the case in adults, the primary trigger thumb symptoms is the catching or locking of the upper part of the thumb in a bent position. But in children, the explanation for congenital trigger thumb is that the sheath of the developing hand is too narrow for the tendon to glide easily through. 

Treatment for trigger thumb in children is usually surgery to loosen the restrictive band. As you’ll read shortly, surgery for trigger thumb in adults is more of a route of last resort.

Trigger Thumb Treatment: Non-invasive

The first mode of treatment is usually to apply a trigger thumb splint to keep the thumb extended and prevent the thumb from engaging in the problematic activity so that the inflammation can go down. There are a number of trigger thumb splints available that restrict one’s motion to varying degrees ranging from noninvasive (check out the Active Innovations Trigger Finger/Thumb splint) to quite immobilizing, as in the Corflex Ultra Fit Abducted Thumb/Wrist Splint.

Wearing a trigger thumb brace at night can also be helpful as many people curl their hands while sleeping, which can be a setback in trigger thumb therapy.

One should also avoid gripping activities when working toward a trigger thumb cure.

Ice and anti-inflammatory medications can also be helpful for reducing inflammation and trigger thumb pain. There are also a number of trigger thumb exercises one can engage in to maintain the thumb’s range of motion during this period of restricted motion. 

Trigger Thumb Exercises

 

In some instances a doctor may recommend a cortisone injection to reduce the inflammation and shrink the troublesome nodule, though this thumb trigger procedure is not always effective.

Trigger Thumb Surgery & Trigger Thumb Release

These next two options are a more permanent cure for trigger thumb, but they also involve more risk and expense.

For trigger thumb release, a professional will apply a local anesthesia and then he or she will cut into the hand with a needle to release the locked finger. This procedure is more effective with the ring, middle and index fingers than it is with the thumb, however. See “Percutaneous Trigger Finger Release” (NF) for more on trigger digit treatment options. 

Trigger Thumb Injection

 

Surgery for trigger thumb is typically only pursued after other methods fail to ease trigger finger symptoms. In this procedure the surgeon will actually widen the sheath through which the tendon of the thumb passes. This can be done with either a regional anesthetic (numbing the arm or hand) or with a general anesthetic (putting the patient asleep). Click here (NF) for a cost/benefit analysis of some trigger thumb treatment options. 

Trigger Thumb Surgery

 

Trigger thumb surgery recovery time is typically less than six weeks, but recovery times of up to six months are not unheard of. During that time, one may need to wear an immobilizing trigger thumb splint and he or she will have to engage in exercises for trigger thumb to return full mobility to the thumb.

For most cases the trigger thumb rehabilitation can be handled without the help of a professional therapist. (Get some post-trigger finger/thumb surgery instructions). (NF)

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