April 21, 2025 Author : Alberto Rocha Pereira (plastic surgery) The disease known as trigger finger is an inflammatory disease - stenosing tenosynovitis - that can affect one or more of the tendons in the hands that are responsible for flexion of fingers (flexor tendons) and that are located in the palm of the hands, extending to the end of the fingers. When tenosynovitis affects the extensor tendons of the thumb, it is called De Quervain's disease, syndrome, or tenosynovitis. Tendons are bands of specialized fibrous tissue. They connect muscles to bones and promote movements, in this case, flexion and extension of the fingers. They are covered by the tendon sheath that produces synovial fluid, a lubricant that allows the tendon to glide within the sheath without friction. When there is a narrowing (stenosis) of the tendon sheath or inflammation and an increase in the tendon's volume, this sliding becomes difficult and the tendon may become “stuck”. The flexor tendons of the thumb and ring fingers are most affected, but the others can also be affected. The exact cause of trigger fingers is unknown, but it is known that there are factors that predispose to its development in adults : Sex , being more common in women; Age , being more common between 40-50 years old; Personal history of other hand diseases , such as Dupuytren's disease and carpal tunnel syndrome, as well as chronic diseases such as diabetes, rheumatoid arthritis, gout, among others. Excessive use and repetitive movements of the hands, which, over time, cause microtraumas. Thus, stenosing tenosynovitis is an important occupational health problem because it tends to affect people who perform tasks that involve frequent use of hands and repetitive movements. Symptoms and diagnosis The main symptoms of trigger fingers are: Initially, pain at the base of the affected fingers , especially when they are moved or pressed. Stiff fingers locked in flexion and painful clicking when attempting to extend , responsible for the sudden characteristic snapping movement that gives the disease its name. Inflamed nodules may be present at the base of the affected fingers. When the disease is more advanced and more serious, there may be pain in the hand, even without movement, and the affected fingers may become stuck in flexion. Over time, it is no longer possible to completely bend or straighten the fingers, resulting in joint stiffness that makes recovery slower and more difficult. The diagnosis is clinical, based on the patient's history and symptoms and the examination performed by the doctor. The presentation is so characteristic when the clinical picture is fully established, that the diagnosis can be made immediately during the consultation, with additional imaging tests rarely being necessary. Treatment of trigger fingers Several possibilities exist to treat stenosing tenosynovitis. Rest Avoiding activities that promote the inflammation of the tendons and may resort to immobilization splints, usually used in the initial crisis and transitory. Medicines To decrease pain and inflammation, which usually relieves symptoms but do not solve the base problem. Local corticosteroid infiltrations Option of unique intervention, due to the risk of complications, namely the breakdown of the tendon. Surgery For release of tendon sheath stenosis, it is usually performed by plastic surgery or orthopedics, in an outpatient clinic and under local anesthesia. It is a minimally invasive intervention, made through a small incision in the palm of the hand, which is healing and allows the resumption of the function of tendon and the respective finger immediately. For these reasons it is generally considered as the first therapeutic option of trigger fingers whose crisis extends for more than 2 weeks despite medical therapy or in cases of repeated crises. People with professional occupations that mainly imply manual tasks need 2 to 3 weeks of recovery before resuming professional activity. The change in habits or workplace should be considered to prevent the involvement of other fingers, which is otherwise inevitable. Meet the reconstructive and aesthetic plastic surgery clinical team from Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
