QUESTION: A 42 year old male office worker was using gardening scissors while tending to his yard on the weekend and noticed his finger had begun to click when he tried to bend and straighten his finger. Sometimes his finger would get locked into his palm too. What is the issue and should he seek treatment?
What Is it?
There are many causes of finger pain. The above example sounds like a classic case of trigger finger but there are many issues which may cause pain or discomfort in the fingers and will require treatment from your hand therapist.
Causes of Finger Pain
Click each condition to find out more about them:
Trigger finger: Trigger finger can result in the inflammation and irritation of the tendon and thickening of the pulley in which the tendon glides through. You may experience tenderness in the palm and the sensation of clicking when bending the finger. If this continues to become aggravated, it may lead to a “triggering” or “locking” of the finger in the bent position which sometimes needs assistance from your other hand to be straightened.
Cubital tunnel syndrome: Cubital tunnel syndrome is the compression of the ulnar nerve as it passes through the cubital tunnel at the elbow. Compression of the nerve can cause symptoms such as numbness, pins and needles, tingling, and pain in the little and ring fingers.
Carpal Tunnel Syndrome: Carpal Tunnel Syndrome is the compression of the median nerve as it passes through the carpal tunnel. Compression of the nerve can cause symptoms such as numbness, pins and needles, tingling, swelling, pain and weakness in the thumb, index, middle and half of the ring fingers.
Skier’s Thumb: Skier’s Thumb is where an injury occurs to Ulnar Collateral Ligament of the metacarpophalangeal joint of the thumb. It often occurs when someone falls on an outstretched hand and the thumb is hyperextended and abducted away from the palm.
Volar Plate: A volar plate injury can occur when the finger is forced into hyperextension – ligaments can partially or fully tear and can avulse with a small fracture fragment when the finger is forced backwards into hyperextension. This can cause swan neck deformity of the finger.
Broken Finger: Lastly, a broken finger (a fracture of one of the 3 phalanges in the finger) will normally cause quite a bit of pain and discomfort in the finger.
A hand therapist can assess and determine what treatment is necessary. Different assessments can help confirm diagnosis, for example, an x-ray or ultrasound. You may also be referred to a doctor for surgical treatment for more severe injuries.
Treatment will vary depending on the cause of the pain. Your hand therapist can provide the following:
• Cast immobilisation
• Education about your condition and appropriate treatment
• Range of movement exercises for uninvolved joints
• A supportive splint to immobilise, protect and support your fingers
• Techniques to help reduce pain and inflammation
• Graduated exercises for range of motion, nerve gliding, and strengthening
Surgical treatment maybe required for more serious conditions. Your therapist can discuss this with you and your GP can arrange a referral to a hand surgeon if required.