Is Trigger Finger the Same as Carpal Tunnel Syndrome?

Article featured on Movement Orthopedics

Are you one of those people whose occupation involves flexing of the wrist day in and day out? If so, you may be at risk for carpal tunnel syndrome. But did you know that there’s another condition that you could be susceptible to if your job involves repetitive hand movements? It’s called trigger finger.

So, what’s the difference between these two conditions? Keep reading to find out.

What Is Trigger Finger?

Also known as stenosing tenosynovitis, trigger finger occurs when a tendon in any of the fingers (including the thumb) becomes inflamed and unable to easily glide through its sheath – the thin layer of tissue surrounding a tendon. Prolonged inflammation can lead to the formation of nodules in the tendon, which ultimately renders the affected finger unable to freely bend and straighten.

The symptoms of trigger finger can range from mild to severe, and can become worse over time. If you have trigger finger, you will likely experience any or some of the following symptoms:

  • Clicking, popping, or snapping sensation when moving your finger
  • Difficulty carrying out basic hand movements, especially those that involve gripping
  • Locking of the finger in a bent position (can suddenly pop straight)
  • Pain and tenderness at the base of your affected finger
  • Stiffness in your finger (mostly noticeable in the morning)

Treatment

Your hand specialist will likely first take a conservative approach to treating your trigger finger. Your doctor may recommend that you rest your hands, wear a splint, and/or perform stretching exercises.

If your symptoms continue unabated, your hand surgeon may give you a cortisone shot to control the inflammation and allow the tendon to glide freely.

If your symptoms don’t respond to nonoperative treatment, your hand surgeon may recommend surgery, in which they will make an incision in the palm area of your hand to access the tendon sheath and cut it to give the tendon more room to move. Another option is percutaneous release, in which your doctor will use a needle to break up the constricting tissue around the tendon sheath, thereby allowing the tendon to move.

What Is Carpal Tunnel Syndrome?

Carpal tunnel syndrome (CTS) occurs when the median nerve – which provides sensation and motor function for the wrist, hand, and forearm – is compressed and unable to function properly.

CTS is also a progressive condition. However, unlike trigger finger, CTS is apparently neuropathic in nature, causing pain, shock-like sensation, numbness, and weakness, all of which can radiate up the forearm and make fine motor skills difficult.

Treatment

Rest, wearing wrist splints, and anti-inflammatories are the common nonsurgical treatments for carpal tunnel syndrome. If none of these provide adequate relief, your hand surgeon may administer cortisone injections to alleviate the inflammation and swelling.

If your symptoms persist despite a lengthy course of nonsurgical treatment, your hand specialist may recommend surgery. Carpal tunnel surgery involves your doctor severing the transverse carpal ligament to allow for more space in the carpal tunnel and consequently relieve pressure on the median nerve.


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

What Is Mallet Finger?

Description

A mallet finger is a deformity of the finger caused when the tendon that straightens your finger (the extensor tendon) is damaged.

When a ball or other object strikes the tip of the finger or thumb and forcibly bends it, the force tears the tendon that straightens the finger (see Figure 1a and 1b). The force of the blow may even pull away a piece of bone along with the tendon (see Figure 2). The tip of the finger or thumb no longer straightens. This condition is sometimes referred to as baseball finger.

Signs & Symptoms

In a mallet finger, the fingertip droops: it cannot straighten on its own power. The finger may be painful, swollen and bruised, especially if there is an associated fracture, but often the only finding is the inability to straighten the tip. Occasionally, blood collects beneath the nail. The nail can even become detached from beneath the skin fold at the base of the nail.

Treatment

Diagnosis

The diagnosis is evident by the appearance of the finger. Doctors will often order x-rays to see if a piece of bone pulled away and to make sure the joint is aligned.

Nonsurgical Treatment

The majority of mallet finger injuries can be treated without surgery. Ice should be applied immediately and the hand should be elevated (fingers toward the ceiling.) Medical attention should be sought within a week after injury. It is especially important to seek immediate attention if there is blood beneath the nail or if the nail is detached. This may be a sign of a nail bed laceration or an open (compound) fracture.

There are many different types of splints/casts for mallet fingers. The goal is to keep the fingertip straight until the tendon heals. Most of the time, a splint will be worn full-time for eight weeks (see Figure 3). Over the next three to four weeks, most patients gradually begin to wear the splint less frequently. The finger usually regains acceptable function and appearance with this treatment. Nevertheless, it is not unusual to lack some extension at the conclusion of treatment. Your surgeon or hand therapist will instruct you about how to wear the splint and will also show you exercises to maintain motion in the middle joint (the proximal interphalangeal joint) so your finger does not become stiff. Once your mallet finger has healed, your surgeon or hand therapist will teach you exercises to regain motion in the fingertip.

In children, mallet finger injuries may involve the cartilage that controls bone growth. The doctor must carefully evaluate and treat this injury in children so that the finger does not become stunted or deformed.

Surgical Treatment

Surgical repair may be considered when mallet finger injuries have large bone fragments or joint mal-alignment. In these cases, pins, wires or even small screws are used to secure the bone fragment and realign the joint (see Figure 4). Surgery may also be considered if splint wear is not feasible or if non-surgical treatment is not successful in restoring adequate finger extension. Surgical treatment of the damaged tendon can include tightening the stretched tendon tissue, using tendon grafts or even fusing the joint straight. Your surgeon will advise you on the best technique in your situation.


Orthopedic Sports Medicine Center of Oregon is located in Downtown Portland Oregon. Dr. Dominic Patillo, one of our Board-Certified Orthopedic Surgeons, specializes in hand surgery. His practice focuses on the treatment of both simple and complex hand and upper extremity conditions as well as general orthopaedic trauma. He is experienced with modern microsurgical techniques including nerve and vessel reconstruction.

Common problems treated include:

  • carpal tunnel syndrome
  • tennis elbow
  • wrist pain
  • sports injuries of the hand and wrist
  • fractures of the hand, wrist, and forearm
  • trigger finger

Other problems treated can include arthritis, nerve and tendon injuries, and congenital limb differences (birth defects).

If you have pain in your fingers, hand, wrist or arm, or if you have other upper-extremity related concerns, please consult our hand specialist Dr. Dominic Patillo for a consultation.