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What Are the Causes of & Remedies for Stiff Back Muscles?
This video of trigger thumb and trigger finger clearly shows the catching of the tendon at the A1 pulley. While the causes of trigger finger are not well known, several factors may increase your risk for developing the condition. These include:. Symptoms of trigger finger often start without a single injury. They may follow a period of heavy or extensive hand use, particularly pinching and grasping activities.
This patient's trigger finger is locked in a bent position. Stiffness and locking tend to be worse after periods of inactivity, such as when you wake up in the morning. Your doctor will be able to diagnose a trigger finger by talking with you about your symptoms and examining your hand.
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Typically, x-rays or other tests are not needed. During the examination, your doctor will check your finger for stiffness and signs of locking.
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Resting your hand and avoiding activities that make it worse may be enough to resolve the problem. Wearing a splint at night to keep the affected finger or thumb in a straight position while you sleep may be helpful. Gentle stretching exercises can help decrease stiffness and improve range of motion in the involved digit.
Over-the-counter medications, such as acetaminophen and nonsteroidal anti-inflammatory drugs NSAIDs , can help relieve pain and inflammation.
Steroid injections. Corticosteroid, or cortisone, is an anti-inflammatory agent that can be injected into the tendon sheath at the base of the trigger finger.
A steroid injection may resolve the triggering over a period of one day to several weeks. If symptoms do not improve with time, a second injection may be given. If two injections do not help the problem, surgery may be considered. Steroid injections are less likely to be effective in patients with diabetes, but may still help avoid surgery.
Our knowledge of orthopaedics. Your best health.
They can cause a short-term rise in blood sugar, so glucose levels in diabetic patients should be monitored after injection. Photo and illustration show a steroid injection into the A1 pulley. If your finger does not get better with nonsurgical treatment, you may wish to consider surgery.
Surgery is elective. The decision for surgery is based on how much pain or loss of function you have in your finger. If, however, your finger or thumb is stuck in a flexed or bent position, your doctor may recommend surgery to prevent permanent stiffness.
Surgical procedure. The goal of the procedure is to release the A1 pulley that is blocking tendon movement so the flexor tendon can glide more easily through the tendon sheath.
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Typically, the procedure is done in an outpatient setting with an injection of local anesthesia to numb the area for surgery. Surgery is performed through either a small open incision in the palm or with the tip of a needle. The A1 pulley is divided released so that the flexor tendon can glide freely.
Although pulleys have an important function in the hand, releasing the A1 pulley should not cause problems in the future. Complications can occur with any type of surgery.