Hand Pain and Movement Conditions

Trigger Finger

A trigger finger occurs when the motion of the tendon that opens and closes the finger is limited, causing the finger to lock or catch as the finger is extended.

Tendons that control the movements of the fingers and thumb slide through a snug tunnel of tissue created by a series of pulleys that keeps the tendon in place. The tendon can become irritated as it slips through the tunnel. As it becomes more and more irritated, the tendon may thicken, making its passage through the tunnel more difficult. The tissues that hold the tendon in place may thicken, causing the opening of the tunnel to become smaller. As a result, the tendon becomes momentarily stuck at the mouth of the tunnel as the finger is extended. A pop may be felt as the tendon slips past the tight area. This why pain and catching may be felt as the finger is moved.

The cause is not always known. Trigger fingers are more common in women than men. They occur most frequently in people who are between the ages of 40 and 60 years of age. Trigger fingers are more common in people with certain medical problems, such as diabetes and rheumatoid arthritis.

Symptoms may include:

  • The presence of a small lump, pain in the palm, and swelling
  • A catching or popping sensation in the finger or thumb joints
  • Stiffness and catching tend to be worse after inactivity such as when you wake up in the morning
  • Discomfort in the knuckles at the palm and finger
  • Soreness at the base of the finger or thumb

Treatment Options:

  • Splinting the finger so that it can rest and heal
  • Limit activities that aggravate the finger
  • Anti-inflammatory drugs or steroid injections to reduce the swelling
  •  Physical therapy may be an option if necessary

 

De Quervain’s Tendonitis

De Quervain’s tendonitis (“swelling of the tendons”) occurs when the tendons around the base of the thumb are irritated or constricted. Thickening of the tendons can cause pain and tenderness along the thumb side of the wrist, which is noticeable when forming a fist, grasping or gripping things, or when turning the wrist. People may also feel a catching or snapping sensation when moving the thumb. The pain and swelling may make movement difficult. Nerves may be irritated, causing numbness on the back of the thumb and index finger.

This condition may be caused by overuse and is sometimes seen with pregnancy or inflammatory arthritis.

 

Dupuytren’s Contracture

Dupuytren’s contracture is a condition where the layer of connective tissue under the skin of the palm of the hand thickens and shrinks which can cause the fingers to bend in to the palms. The bent fingers are usually unable to be fully straightened and the ring finger and pinky finger are the fingers most commonly affected. The middle finger may be affected in advanced cases, but the index finger and the thumb are nearly always spared.

Dupuytren’s contracture progresses slowly and is usually painless. This condition can make it difficult to perform certain functions using your hand. Since the thumb and index finger are not usually affected, many people do not experience much inconvenience or disability with fine motor activities such as writing.

There is no confirmed cause of Dupuytren’s contracture, but it commonly runs in families. Other factors such as trauma due to manual labor, diabetes, alcoholism, epilepsy, and liver disease, may also contribute to this condition.

Symptoms may include:

  • Thickening of the skin on the palm of your hand
  • Your hand may appear puckered or dimpled.
  • A firm lump of tissue may form on your palm. This lump may be sensitive to the touch but usually is not painful.
  • In later stages of Dupuytren’s contracture, cords of tissue form under the skin on your palm and may extend up to your fingers. As these cords tighten, your fingers may be pulled toward your palm, sometimes severely.
  • Dupuytren’s contracture can occur in both hands, though one hand is usually affected more severely than the other.