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Trigger Finger And Hand Therapy

Trigger finger which is medically termed as ‘stenosing tenosynovitis’ is among the five causes of disability in the human hand.

Patients with trigger finger report experiencing:

• pain
• locking/jamming
• swelling

of the tendon and tendon sheathe at the base of the finger with trigger finger. Although it tends to affect adults between 40-70 years of age, there are some children under the age of 8 who are prone to it (moreso in the thumb).

clinical PRESENTATION

The most classic sign of trigger finger are a combination of or all of the following:

• locking of a finger in a flexed position (sometimes can be straightened still, or in severe cases, it becomes locked in that position)
• pain and tenderness at base of finger
• stiffness and tightness especially in morning or after prolonged rest

In some cases, there may be involvement of multiple fingers at the same time (2, 3 or more trigger finger in the same hand), especially for individuals who are more at risk such as patients with:

• who are pregnant
• diabetic
• rheumatoid arthritis

PATHOPHYSIOLOGY

For a normal flexor tendon for the finger in the hand/palm, the tendon glide inside a tendon sheath (it's like a protective tunnel blanket).

What happens is that:

• due to excess repetitive flexing
• direct damage
• other factors

the tendon sheathe starts to thicken (the tendon itself may thicken too) and that causes more friction and sometimes "jamming" of tendon-tendon sheathe. In many cases, a nodule (ball-like structure) can develop in the tendon which then will block movement.

It's this nodule that causes the finger to be locked in flexed position, and there are 4 stages of trigger finger:

1. Stage 1: tenderness and pain at base of finger
2. Stage 2: clicking and snapping of affected finger, able to extend without external help; with pain and swelling
3. Stage 3: clicking and locking of affected finger, needs the other hand to help extend; pain, stiffness and swelling
4. Stage 4: locking, unable to extend unless with lots of help/rest; pain, stiffness and swelling

Normally by stage 2-3, we recommend a direct injection to release and decrease the swelling; at Stage 4, patient almost always will get immediate relief from surgical trigger finger release.

CAUSES of trigger finger

The most common causes of trigger finger revolves around repetitive force-generating activities such as:

• house work: wringing cloth/mop repeatedly
• driving and holding tightly to steering wheel for long time
• lots of gripping activities such as pulling, climbing (including sports and weight lifting)

Of course, it can be caused or aggravated by:

• direct trauma such as blows or fall to the ground
• tendon laceration
• contributing medical conditions such as gout, diabetes, rheumatoid arthritis
• can coexist with other repetitive strain injuries such as carpal tunnel syndrome, De Quervain's tenosynovitis (mummy's/Blackberry thumb)
  

hand therapy management

What the hand therapist will do depends on how severe and what medical interventions has been done:

1) Conservative (non surgical)

• Splinting for trigger finger
• Protected range of motion exercises to maintain joint and tendon range, which also provides nutrition to affected tendon and tendon sheathe (in the earlier stage)
• Progressive to resistive and strengthening activities
• Ultrasound therapy for accelerated soft tissue healing
  

2) Post Trigger Finger Surgical Release

• Splinting for trigger finger
• Wound care and wound management to prevent joint and tendon glide stiffness, and prevent infections
  
• Protected range of motion exercises to maintain joint and tendon range, which also provides nutrition to affected tendon and tendon sheathe (in the earlier stage)
• Progressive to resistive and strengthening activities
• Ultrasound therapy for accelerated soft tissue healing

For more severe cases that do not respond to the above conservative management, other treatment options are:

• steroid injection (by a GP, sports physician or orthopedic surgeon)
  
• trigger finger release (has some risks related to surgery eg scarring, infection, etc)
  

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• Email your preferred physiotherapy appointment slot to contact@phoenixrehabgroup.com or
• WhatsApp / SMS your name, preferred date, time and clinic location to +6588001830 (Novena).
• Clinic locations: see how to get to us here

Phoenix Rehab Singapore Core Services And Specializations

Phoenix Rehab Group works with specialist physiotherapists and specialist rehab therapists who are highly trained, qualified, experienced and passionate to provide high level of expert care to our patients.

PHYSIOTHERAPY & PHYSICAL THERAPY General Orthopedic Physio Back and Neck Physio Sports Physio Post-surgery Physio Women's Health Physio Indiba (Radio-Frequency) Physiotherapy Dry Needling Physio

HAND THERAPY &  SPLINTING Patients who sustained injuries to their elbows, forearms, hands, wrists (sprains and fractures) and fingers, and requires Hand Therapy to increase the function of their hand following injuries or post-operations and custom made hand splints.

CLINICAL PILATES & WELLNESS PILATES Clinical Pilates is a form of physical exercise that focuses on posture, core stability, balance, control, strength, flexibility, and breathing. It is a system of safe and effective exercises, which meet specific individual needs, to treat a wide range of injuries and conditions.

TRADITIONAL CHINESE MEDICINE (TCM) Pain Management TCM Acupuncture TCM Gua Sha TCM Cupping TCM

DEEP TISSUE RELEASE & SPORTS MASSAGE THERAPY Sports and deep tissue release massage helps to increase nutrient-rich blood flow to tired , tight and tense muscles to accelerate recovery and shorten downtime. It also helps prevents muscles from scar tissue micro-tears (and future ruptures), and increases muscle performance. When done regularly it will keeps your muscles and you healthy and fit and have body/movement-confidence.

PERSONAL TRAINING Having a dedicated personal trainer/personal training helps you get faster and better health, fitness and wellness results. You can expect better fat loss and muscle gain, have reduced risks of injury, establish effective exercise and health habits as well as overcome those annoying "flatline plateus" to breakthrough to your next level of fitness and weight loss.

All our allied health therapists and TCM physicians are fully insured and registered with Allied Health Professions Council (AHPC) and Traditional Chinese Medicine Board (TCMB).

See our entire team here by location and specialization.

At the first session, our specialist physiotherapists will carry out a thorough assessment, helping them to select the most appropriate treatment to help you recover as well as provide treatment in the same session. 

Follow up sessions are inline to provide expert treatment for your pain as well as prescribing specific exercises to reduce your risk of re-injury and giving you a long term solution.

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We do not rely on advertising - instead, we prefer and appreciate the goodwill and positive reinforcement from patients. When you have the opportunity, please take the time to tell your family, friends and physicians about the positive results and experience you have had in our clinic.

book a physiotherapy appointment today

• Email your preferred physiotherapy appointment slot to contact@phoenixrehabgroup.com or
• SMS your name, preferred date, time and clinic location to +6588001830 (Novena).
• Clinic locations: see how to get to us here