By Alexander Germanis
Few things are as annoying as, when trying to open a drawer, something within that drawer catches and prevents the drawer from opening.
The condition known as trigger finger, or stenosing tenosynovitis, is similar to the stuck drawer problem. As described in the first part of this series, trigger finger is an inflammatory condition in the fingers or thumb of the hand. Stuck in a curled position — as if pulling a trigger — when the finger is popped open, it will quickly snap straight like a trigger being released, thus giving the condition its name.
Dr. Jerome Oakey, a surgeon at McLean County Orthopedics specializing in the hands and wrists, explains that the causes of trigger finger have a great deal to do with the anatomy of the finger pulley system. When the tendon running through the finger encounters problems as it passes through the fascia pulleys, trigger finger may result. “You can get inflammation in the tendon,” he states, “and you essentially form a knot in the rope as it runs through that pulley.”
“There was a bad winter a couple of years ago and I had a lot of people that came in after snow shoveling,” he recalls. The same thing happens with players of certain sports. “I see a lot of people who are taking golf lessons or play golf a lot. Because, if you imagine anything that you are forming a strenuous grip on, where the handle sits in line with those pulleys, it can be very problematic.”
The condition also more commonly presents itself depending on the time of the day. “People will say it will more typically show up in the morning,” Dr. Oakey says. “They say they wake up and their finger is stuck down; they have to use their other hand to pry it open. They can then move it [normally].”
Dr. Oakey explains that the finger’s pulley system anatomy is the reason for the morning being the worst time of the day for sufferers. “If you can imagine a rope sitting through a series of pulleys, and at night it’s bathed in fluid, the rope absorbs some of that surrounding fluid. Well, suddenly that knot becomes much bigger. When you run the rope through the pulley, the knot gets stuck on the other side because it’s got the extra fluid from being bathed in a bath overnight.”
The rope, however, acts like anything fibrous or porous like a sponge. “The more you move your hand in the morning, the more you wring out that extra fluid from the tendon,” the doctor says. “Very commonly, they take a shower and they feel like it loosens up after that.”
People who swing a club are not the only ones susceptible to trigger finger though. Women tend to have it more often than men. Also, people with diabetes are far more likely to suffer from it. Although it is not fully understood as to why, it could have to do with the higher glucose levels in a diabetic, which can alter the protein balance and cause the collagen to stiffen.
“Another unique population beside diabetics who are more likely to get this are people with rheumatoid or inflammatory arthritis,” Dr. Oakey adds. “They can often have underlying arthritis in the joint as well, which can make it a little more challenging to sort out where the pain is coming from.”
Just like arthritis, trigger finger can be very painful and can be diagnosed after a physical exam by a physician. Although there can sometimes be external signs such as a swollen area or bump over a joint in the hand, these are not always present and an exam is essential before any solutions can be put into effect.
To find out which methods are utilized to fight this inflammatory condition, read Trigger Finger — Part 3 in next month’s issue of Healthy Cells Magazine®.
For more information, you may contact Dr. Oakey at McLean County Orthopedics at 309-663-6461 or visit www.mcleancountyorthopedics.com. The practice treats all types of orthopedic conditions and offers a comprehensive range of services. Their office is located at 2502 E. Empire in Bloomington.