Chiropractor Chandler AZ
Trigger finger is also called stenosing tenosynovitis. It is characterized by a snapping of the finger when it is straightened. The finger may feel stiff or stuck, but with continued force it quickly extends with a snap.
Trigger finger tends to occur in people who actively use their hands for work or hobbies. A continued, repetitive movement creates inflammation of the tendon sheath and eventual thickening. This thickening can create a bump or ball that jumps when the tendon passes through the tendon sheath.
As the tendon has slowly increased in thickness over time, many patients have felt that irritation and mild soreness. They found themselves rubbing the area because of the mild discomfort felt with repetitive finger activities. Eventually the movements create clicking and popping sensations that startles many people and leads them to seek treatment. If the condition continues to get worse, the bump enlarges in size and more popping and clicking is felt. It be can become very difficult to flex and extend the finger, especially first thing in the morning.
The anatomy of the hand is quite unique. It utilizes many unique features to accommodate the multiple muscles, tendons, ligaments, arteries, and nerves in the hand. The small tendons that flex the finger slide inside of a protective tunnel. I like to describe this is a rope sliding inside of a straw. Normally the rope can slide without friction or restriction. Unfortunately, injury and damage to the rope has caused it to enlarge in size and extra healing tissue is wrapping around the rope, which makes it difficult for that section to slide into and out of the straw. That enlarged bump in the rope produces the snap as the section of rope is forced into the straw and when it pops out of the straw. Eventually that section of rope can become so big that it prevents the tendon from sliding through the straw at all.
Initial treatments for trigger finger involve decreasing the inflammation and irritation to the tendon and sheath. Ice and rest will help reduce the irritation and inflammation around the tendon. Light stretching should be performed to help stimulate repair and prevent a further increase in the size of the bump.
Traditional office treatments include heat, ice, electric, and ultrasound therapy to decrease pain and inflammation in the hand muscles and tendons. Specific stretching and light exercises are shown to enhance the therapy and treatments. Graston technique and active release technique are excellent at breaking up fascial adhesions and scar tissue. Trigger finger is an accumulation or fibrosis of tissue around the tendon. These treatments help break up scar tissue, which will allow the tendon to slide back inside the sheath. Over a series of treatments patients feel the bump decrease in size and tenderness.
Some people are more likely to form scar tissue or develop trigger finger than others. It is often a benefit to treat the entire hand and the other hand’s flexor tendons to remove any irritation or increase fibrosis on the tendons that may lead to future development of trigger finger.
One of the newest treatments for trigger finger that has provided significant relief for many patients and enhanced traditional treatments is cold laser therapy. Cold laser, or low level laser, therapy is a unique treatment that utilizes specific wavelengths and frequencies of energy to stimulate processes within the cells and tissue. Class IV or cold lasers provide a tremendous amount of energy that penetrates deep in the muscles and tendons to trigger repair and healing processes. Specific wavelengths are also excellent at decreasing inflammation in the accumulation of inflammatory cells. The laser stimulates blood flow, which brings more nutrients to the area for healing and also helps wash away the waste products. In low level laser therapy, wavelengths stimulate internal cellular processes to increase ATP energy. Cells use ATP like cars use gasoline. By providing extra gasoline to the system, the body is able to spend more of the energy on repair and healing processes, and thus shortening the overall treatment time.
Specific wavelengths of low-level lasers are also beneficial for decreasing fibrosis or scar tissue formation. During the body's normal healing repair mechanisms, it commonly produces bad tissue or scar tissue. Patients who are more likely to form scar tissue benefit from the cold laser because it decreases the amount of bad tissue formed during the treatment and healing phases.
Cold lasers are an excellent treatment modality that can improve overall healing and recovery time. Trigger finger is a condition that benefits from many types of treatment modalities and options. It is also a condition that responds best in the early stages. Waiting for severe scar tissue fibrosis can result in severe damage to the soft tissues in the hand. Surgical intervention may become the only treatment option in severe cases. Such as with many things in healthcare, it usually does not go away on its own and requires some type of intervention. Earlier intervention is better - do not wait until it is too late.