_________________________ Caitlin Geng _ 6/11/2022
reviewed by Angelica Balingit, MD
Some conditions cause the finger or toe joint tissue to thicken, which makes movement difficult. This, in turn, may affect how the joint bends, leading to a locking sensation. The potential causes of this include injury and arthritis.
Tendons surrounding the finger and toe joints control the movement of the digits. A sheath, called the synovial membrane, encloses the tendons. If the synovial membrane becomes inflamed, it can affect the tendon’s movement. The tendon may become stuck on the sheath and cause a finger or toe joint to lock in place.
This article discusses what finger and toe joint locking is, other associated symptoms, causes, and treatments alongside lifestyle measures that may help prevent or manage it.
What is it?
People also refer to locking or catching of the joints in the digits as stenosing tenosynovitis. When this occurs in the finger joints, people also call it “trigger finger,” but it can affect any finger joints.
Tendons are cord-like structures that attach the muscles to bones. When a specific muscle contracts, the flexor tendons pull on the bones of the fingers or toes, which causes them to bend. Flexor tendons run from the forearm to the fingers’ ends across the palm. Each flexor tendon that leads to a finger or toe is encased in its structure, called a sheath. The sheaths attach to the finger and toe bones.
The bands of tissue — a pulley — sit along the sheaths, which hold the tendons near the bones as they flex and stretch.
In people with stenosing tenosynovitis, the pulley thickens, which makes it harder for the tendon to move, which in turn causes difficulty bending the joint of the finger or toe. The tendon may eventually become inflamed and develop nodules on its surface. When this happens, the bumps can catch on the pulley and cause a locking sensation.
Symptoms
Symptoms of stenosing tenosynovitis may occur after someone uses their hand for repetitive activities or may develop gradually due to other causes. Symptoms include:
a digit, usually a finger, becoming locked in a bent position
a popping or catching feeling when bending the digit
pain when straightening or bending the digit joint
a sensitive or painful lump at the base of the digit
stiffness in the joint, especially upon waking, which may ease throughout the day
Causes of joint locking
Doctors do not know the exact causes of finger and toe joint locking, but various risk factors can increase a person’s chances of developing the condition. Associated conditions include:
Rheumatoid arthritis (RA): An autoimmune disorder in which the immune system mistakenly attacks healthy cells in the joints, which causes inflammation in the fingers and toes.
Gout: Crystals build up in the joints and affect their movement. Gout typically affects the big toe.
Carpal tunnel syndrome: This occurs when the median nerve in the hand is compressed and can cause pain, numbness, and tingling.
Issues affecting the thyroid: Conditions such as hyperthyroidism and hypothyroidism can affect the structure and function of the muscles and joints.
Amyloidosis: This occurs when specific proteins in the body build up into deposits in the tissues and organs. This protein buildup could cause pain in the joints. 2021 research shows that people with amyloidosis commonly report trigger fingers. Further research must determine how the diagnostic process can help reduce the risk.
Diabetes: This chronic condition affects how the body breaks down glucose from food and turns it into energy. Trigger finger is a possible complication that may affect people with diabetes, and medical professionals will consider these factors during diagnosis.
Injury or trauma: For example, dislocation, when a bone slips out of its joint.
Developmental: A child’s flexor tendon and sheath may not match in size, referred to as a pediatric trigger finger.
Infective tenosynovitis
Certain pathogens may result in infective tenosynovitis due to injury or the spread of infection. A 2022 article states that 2.5–9.4% of people will develop infectious tenosynovitis.
A person should consult a doctor if they suspect infection to receive a prompt diagnosis and determine the type of organism and treatment. Common organisms include Staphylococcus aureus in 40–75% of cases and MRSA in 29% of cases. Infectious tenosynovitis treatment varies based on the type of organism. Doctors will usually prescribe a course of antibiotics with its duration depending on the severity of the infection.
For early signs of infections, other possible treatments include sheath irrigation — cleaning the tendon sheath — and catheter-directed therapy. Debridement may be an option for people with late stages of infection, where doctors remove debris from an infected area.
General management and treatment
Treatment for joint locking in the finger or toe depends on the cause and severity of the condition. It may include:
resting the joints and avoiding activities that could worsen the condition
performing gentle stretching exercises to help with stiffness and improve range of motion
taking over-the-counter (OTC) medication to help with pain and inflammation, such as nonsteroidal anti-inflammatory drugs (NSAIDs)
wearing a splint, especially while sleeping
having a corticosteroid injection, which can reduce inflammation
undergoing surgery, in some cases, to release the affected pulley and allow the tendon to glide more easily, which should stop the locking sensation in the digit
Lifestyle changes
A person may develop joint locking in the digits from repetitive activities. Avoiding or modifying repetitive activities — especially gripping or pinching hand motions — could help prevent locked joints.
Lifestyle measures to manage associated conditions may help avoid or improve joint locking. These may include following a balanced diet and exercising regularly.
Summary
Joints in the digits may lock when the membrane surrounding the tendons — the synovial sheath — becomes inflamed. This inflammation can cause difficulty bending or straightening the joint and cause a catching or locking sensation, which can be painful.
Experts do not know the exact causes of joints in the fingers and toes locking, but they associate joint locking with several other conditions. These include RA, carpal tunnel syndrome, diabetes, and injuries such as dislocation.
People can treat joint locking in the digits with OTC medication, gentle stretching, rest, or splinting. In more severe cases, a doctor may need to administer a steroid injection, or a person may require surgery.
___________________ Rachel Nall, MSN, CRNA _ 21/02/2022
reviewed by Nancy Carteron, M.D., FACR
Trigger finger is a condition in which a person’s finger locks or catches if they try to straighten or bend it. Depending on the condition’s severity, doctors will recommend either surgical treatments, medications, or some home remedies.
Most people experience trigger finger in the fourth (ring) finger or the thumb, but the condition can affect any of the fingers.
Trigger finger is the result of inflammation in or around the flexor tendons. Flexor tendons are responsible for moving the fingers.
More specifically, it occurs due to the inflammation of “pulleys,” which are bands of tissue that attach the finger bone to the flexor tendon. The inflammation of the pulleys affects the finger’s ability to move smoothly.
Read this article to learn about the treatment options for trigger finger, as well as some of the causes and the prevention methods.
Nonsurgical treatment
There are a number of nonsurgical options to treat trigger finger.
A doctor will usually recommend treating trigger finger nonsurgically when a person starts having problems with the condition. People can try most of these methods at home. They include:
Resting
As trigger finger can result from overuse, simply resting the hand and finger can often reduce symptoms. People may need to rest this part of the body for 1–2 weeks to see results.
Taking over-the-counter medications
Taking nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, may help reduce pain and inflammation from trigger finger.
Splinting
A trigger finger splint usually wraps around the palm and has a small covering for the lower portion of the affected finger. This splint allows a person to bend the top portion of their finger without moving the part closest to the palm.
Exercising the hand and finger
Hand and finger exercises can stretch and strengthen the muscles around the tendons, which may help reduce stiffness and pain. However, it is important to avoid overexercising and to discontinue any exercise that increases pain.
Using adaptive tools
Placing protective, soft-grip covers over steering wheels, power tools, bicycle handles, and even pens can help reduce the effects of friction and potentially lessen the inflammation that leads to trigger finger.
Getting steroid injections
Doctors can inject corticosteroids around the tendon sheath in the affected finger. These drugs may help reduce the incidence of trigger finger pain and limit the impairment of movement. Sometimes, a person may require two or three injections to experience symptom relief.
According to the findings of a retrospective study in The Journal of Hand Surgery, 39% of people with trigger finger reported long-term relief after a second or third trigger finger injection.
Those who received three injections for trigger finger reported relief of their symptoms for an average of 407 days.
Surgery
If a person tries nonsurgical treatment methods but still experiences trigger finger, a doctor will often recommend surgery. A doctor is also likely to recommend surgery if a finger becomes permanently “caught” or bent out of position.
Surgeons usually take one of two approaches to treating trigger finger. The first is to make a small incision in the palm to release the pulley that is affecting finger movement. The second is to insert a needle into the affected area to release the pulley.
There is some evidence to suggest that open surgery may reduce the incidence of pain and other symptoms to a greater extent than steroid injections. However, this research only reports on the first 6–12 months after surgery. Therefore, doctors do not yet know whether surgery provides long-term relief from trigger finger.
Causes
Sometimes, a person develops trigger finger for no known reason. Other times, one of the following factors may be responsible:
Certain medical conditions: Diabetes and rheumatoid arthritis are known contributors to trigger finger.
Finger overuse: People who work with their hands, especially those performing vigorous activities using machinery or tools that require gripping, have an increased risk of developing trigger finger.
Contact friction: Sometimes, the repeated use of power tools that vibrate in the hand or even holding bicycle handles can lead to trigger finger.
A specific injury does not usually cause trigger finger.
The condition most commonly affects those in their 40s and 50s, according to an article in the journal Current Reviews in Musculoskeletal MedicineTrusted Source. The article also states that females are about six times more likely than males to experience trigger finger.
People with diabetes are also at a higher risk of trigger finger. An estimated 10% of people with diabetes have trigger finger compared with 2–3% of the general population.
Symptoms
The symptoms of trigger finger typically include:
a visible or tender lump on the palm at the finger’s base
a finger that catches, locks, or makes popping noises with movement
pain and discomfort when straightening or bending the finger
A person will often notice their symptoms worsening after a period of using their hands more. The symptoms are also usually more prominent in the morning.
As the symptoms of trigger finger are so distinctive, a doctor can usually diagnose the condition by carrying out a physical examination.
Exercises for prevention
Exercises to stretch and strengthen the wrists and fingers can help people with trigger finger and those with a history of the condition prevent and reduce pain. Some examples of exercises that may help prevent trigger finger include:
Wrist stretching
To stretch the wrists:
Place the palms together in front of the chest, feeling a gentle stretch in the wrists.
Slowly lower the palms toward the belly button to increase the stretching sensation.
Hold this position for 10 seconds, then release.
Fingertip bend
This exercise helps bend the top of the finger joint. People can follow the steps below to perform it:
Hold one hand at face level and place the opposite hand around the painful finger, just below the fingertip.
Slowly bend the fingertip at the top joint, keeping the remainder of the finger straight.
Repeat 10 times on each painful finger.
Middle joint bend
A person can try this exercise after the fingertip bend:
Hold the affected finger at the base of the finger joint and bend it at the middle portion of the finger.
Slowly straighten the finger.
Repeat 10 times.
Although the exercises above may seem simple, they are very effective in helping a person relieve stress and tension in their fingers and hands.
Another option is to knead or shape clay or playdough. This activity is also an effective way of stretching the hand and fingers. A person should repeat these exercises three to five times a day whenever possible.
Summary
Trigger finger can be painful and keep a person from performing everyday activities. If a person thinks that they may have trigger finger, they should see a doctor for treatment recommendations before their condition worsens.
Home treatment methods are often very effective, and exercise can help prevent the condition. Doctors will recommend surgery only in severe cases.
