Flexor Tendinitis of the Thumb and Fingers

Flexor Tendinitis of the Thumb and Fingers

What is flexor tendinitis?

It is swelling of the tendon(s) that bends the fingers. Flexor tendinitis is also called Trigger Finger. The flexor tendons are smooth, thick ropes that allow the finger to bend and straighten. There are no muscles in the fingers. Instead, the tendons connect the muscles of the forearm to the finger bones and the muscles pull on the tendons to bend the fingers. It commonly affects the thumb and ring finger, but can affect other fingers.

What causes flexor tendinitis?

Tendon swelling and inflammation result from repetitive strain and strenuous activities involving the fingers and thumb. Inflammation narrows the space around the affected tendon, the tendon thickens and may form nodules at the base of the affected fingers. As the tendon tissue expands (swells) it impinges on the tendon causing pain and restricted motion.  The cause is unknown, but certain medical conditions like rheumatoid arthritis and diabetes increase the risk of developing trigger finger. Trigger finger commonly affects farmers, musicians and industrial workers.

What are the symptoms of trigger finger?

Primary symptoms are tenderness and swelling in the palm of the hand, at the base of the affected fingers; and stiffness, pain and clicking in the affected finger joints. Without treatment trigger finger will progress to locking of the affected finger. Stiffness and locking are typically worse upon waking. In severe cases, the finger locks and becomes stuck in the bent position.

How is trigger finger diagnosed?

Your Ortho Illinois Hand and Wrist doctor will discuss your symptoms and conduct a physical examination to check for stiffness, tenderness, swelling, and range of motion. 

How is it treated?

Conservative measures including rest, ice, splinting, and gentle stretching exercises help to decrease stiffness and improve range of motion. Over- the- counter medications can help to relieve pain and inflammation.

Steroid injections may be recommended to reduce inflammation and improve symptoms, and temporarily avoid surgery. If that fails, surgery will be considered.

When is surgery a good option?

When conservative treatment fails, and there is significant pain and loss of function, surgery may be recommended. However, if your finger or thumb is stuck in a bent position surgery can release the tendon and prevent permanent flexion and stiffness.

Surgery is an outpatient procedure called percutaneous release performed under local anesthetic to release constriction of the tendon. For more severe cases, surgery at the base of the affected finger is performed.

Most patients who have surgery will find relief from the pain and stiffness. Physical therapy may be recommended to restoration of range of motion, and relieve stiffness after surgery.