Snap finger syndrome (stenosing tendovaginitis) is inflammation of the tissues of the tendon and the lining that covers it. This is a rather painful condition in which the finger snaps or gets stuck when bent. When the disease is severe enough, the finger gets stuck in a flexed position and then releases with a click, like pulling a trigger. The risk group includes people whose professional activities are associated with frequently repetitive movements, as well as those suffering from arthritis and diabetes. When prescribing treatment, the doctor will take into account the severity of the disease, as well as its causes. Therefore, an accurate diagnosis is of paramount importance.
Part 1 of 3: Home Treatment
Step 1. Give yourself some rest if your work involves repetitive movements
In most cases, stenosing tendovaginitis is caused by constant stress on the hand or frequent flexion of the thumb or index finger. Farmers, typists, workers or musicians are at risk because people in these professions constantly repeat the same movements with their thumb and forefinger. Even smokers are at risk because they constantly use a lighter. If possible, stop or limit repetitive finger movements and the pain and discomfort will most likely decrease on their own.
- Tell your boss about your problem, and he may give you another job that does not require repetitive finger movements.
- Snapping finger syndrome most commonly affects people between the ages of 40 and 60.
- In addition, women are more likely to suffer from this disease.
Step 2. Apply ice
A cold compress is a very effective treatment for almost all minor injuries of the musculoskeletal system, including stenosing tendovaginitis. An ice pack (ice wrapped in a thin towel or frozen gel compress) is applied to the inflamed tendon (it usually looks like a small bump or nodule on the bottom of a finger or palm, and is very painful to the touch) to reduce swelling and pain. Apply ice every hour for 10-15 minutes. This will reduce pain and swelling.
Apply ice to the damaged area and secure with a bandage or elastic bandage. This will reduce the inflammatory process. However, do not tie the elastic bandage too tight, otherwise the complete restriction of blood flow can lead to even more damage to the finger
Step 3. Take non-steroidal anti-inflammatory drugs (NSAIDs) that are available without a prescription
Non-steroidal anti-inflammatory drugs such as ibuprofen, naproxen, or aspirin are used as symptomatic treatment. These drugs are recommended to relieve pain and inflammation. The dosage for adults is usually 200-400 mg taken by mouth every 4-6 hours. Note that these drugs have side effects: abdominal pain and liver and kidney problems. Therefore, do not use these medicines for more than two weeks. Non-steroidal anti-inflammatory drugs (NSAIDs) can cause gastritis and ulcers.
Symptoms of stenosing tendovaginitis: immobility (especially in the first half of the day), a "click" sensation when extending the finger, a painful nodule at the base of the finger and difficulty in extending it
Step 4. Stretch the affected brush
Follow this advice if the problem has not yet taken a serious turn, the disease is only at an early stage. Place your palm on the table. Gently stretch the ligaments of the hand, pressing the entire palm against the surface of the table. Lock the position and hold for 30 seconds. Repeat three to five times a day. Alternatively, try stretching the sore finger with your other hand, applying gentle pressure and massaging the sore nodule (if visible).
- Soak your Epsom salt. Place your hand in the Epsom salt bath for 10-15 minutes. This procedure helps relieve tension and pain in the affected tendon.
- Most often, this pathology occurs on the thumb, middle and ring fingers.
- Sometimes stenosing tendovaginitis affects several fingers at the same time, and in some cases, the fingers of both hands can be affected.
- A hand massage performed by a physical therapist can help in this case.
Part 2 of 3: Medical Treatment
Step 1. Pick up your finger splints
Your doctor may recommend that you wear splints at night to keep your fingers extended while you sleep. You will have to wear splints for about six weeks. Thanks to the use of a splint, you will not collect your fingers into a fist during sleep, which aggravates the course of the disease.
- Remove the splint throughout the day for finger stretching and gentle massage.
- Alternatively, you can make a splint yourself. To do this, purchase an aluminum splint and waterproof medical tape from the pharmacy.
Step 2. Ask your doctor about corticosteroid injections
Injecting a steroid into the tendon area can help reduce inflammation and restore normal finger movement. Typically, corticosteroid injections are given primarily for stenosing tendovaginitis. Usually, the doctor will prescribe two injections (3-4 weeks apart). This is a fairly effective method of treatment; in 90% of cases, recovery has occurred. The most common drugs are prednisolone, dexamethasone, and triamcinolone.
- Possible complications of corticosteroid injections include infections, bleeding, decreased tendon reflexes, muscle atrophy, and nerve irritation or damage.
- If corticosteroid injections are ineffective, your doctor may suggest surgery.
Step 3. Surgical intervention
The main indications for surgery are ineffectiveness of corticosteroid injections, splints, or other methods discussed above. In addition, your doctor may suggest surgery if your finger is bent or wedged when bent. With this pathology, two types of surgical intervention are used: open ligamentotomy and percutaneous ligamentotomy. With an open ligamentotomy, an incision is made at the base of the affected finger, which releases the annular ligament layer by layer. The dissection is performed along its lateral surface. With percutaneous ligamentotomy, the ligament is dissected without an incision in the skin using a thin needle.
- Typically, these types of surgery are performed on an outpatient basis under local anesthesia.
- Possible complications after surgery include infections, an allergic reaction to anesthesia, nerve damage, and prolonged swelling / pain.
- The relapse rate is only about three percent. The operation may be ineffective if the patient has diabetes.
Part 3 of 3: Preventing Potential Complications and Diagnosing Other Diseases
Step 1. Treat the infection or allergic reaction
In some cases, snap finger syndrome is caused by an infection of the synovium. If the joints or muscles of your finger are red, warm to the touch, and inflamed for hours or days, seek immediate medical attention because these signs indicate an infection or a possible allergic reaction to an insect bite. Standard treatment is incision and drainage, warm water and salt baths, and antibiotics may be needed in some cases.
- Diseases caused by bacteria are the most common. The risk of infection is higher with poor wound care. In addition, an ingrown toenail and puncture wounds can lead to serious infections.
- Allergic reactions to insect bites are fairly common, especially with bee, wasp and spider stings.
Step 2. Treat the dislocated joint
Dislocation of a finger joint is sometimes mistaken for stenosing tendovaginitis, because the patient experiences painful sensations, as well as a visible change in the joint, similar to what occurs with snapping finger syndrome. The cause of this type of injury is often a blow to the joint with a blunt object. Snap finger syndrome, in turn, is associated with constant stress. Therefore, if you suspect a dislocated finger joint, seek immediate medical attention. In this case, the doctor will adjust the joint for you. Once your doctor has repositioned your joint, he will give you recommendations similar to those given for snapping finger syndrome: rest, anti-inflammatories, ice and splinting.
- Fractures and dislocations are not always easy to distinguish. In some cases, additional research methods are required, such as x-rays.
- You can see an osteopath, chiropractor, and physical therapist besides your family doctor.
Step 3. Treat arthritis
Snap finger symptoms are very common in rheumatoid arthritis and gout. Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation of the joints. Prescription anti-inflammatories and immunosuppressants are prescribed for rheumatoid arthritis. Gout is an inflamed joint condition caused by the deposition of uric acid crystals. The joints throughout the body are at risk, but the fingers and toes are most affected. Gout is associated with shortening of the tendon, which in turn leads to contracture (flexion of the finger joints).
- Rheumatoid arthritis usually affects the hands and wrists. Over time, arthritis can disfigure the joint.
- Your doctor may ask you to have a blood test to look for specific markers for rheumatoid arthritis.
- To reduce your risk of gout, limit your intake of foods rich in purines, such as organ meats, seafood, and beer.
Consult your doctor if necessary. Your doctor will prescribe the appropriate treatment for you
- Eat cherries and foods high in vitamin C. This is the best way to fight gout attacks.
- Recovery time after surgery depends on the severity of the condition and the method chosen. But, as a rule, the recovery period takes about two weeks.
- Stenosing ligamentitis of the thumb in infants is treated, as a rule, with the help of surgery, since this pathology will worsen as they grow older, the fingers will remain in a bent position.