What can I do to protect my trigger finger from being caught while performing my job?

Q: I work in a meat packing plant where safety is always an issue. As a result of my work, I've developed a trigger finger in the ring finger of my left hand. Fortunately, I'm right-handed so it doesn't cause too many problems. But I'm wondering what I can do to protect that finger from getting caught on things without making it difficult to do my job.

A: There is nothing more annoying than having your finger lock up on you and not being able to open your hand. Your hand gets stuck inside pants pockets. You can't reach into your pocket and pull out your wallet. Even taking care of business in the bathroom can become a challenge. We can imagine working in a meat packing plant would create its own unique challanges.

Trigger finger is a condition affecting the movement of the tendons as they move the finger(s) toward or away from the palm of the hand. In the early stages of this condition, there is pain, swelling, and a clicking sensation when moving the affected finger. But as the problem gets worse, the finger can get stuck or locked in a bent or straight position.

Treatment most often begins with conservative (nonoperative) care. Usually patients are put on antiinflammatory medications and given a splint. The finger splint is meant to help reduce symptoms. It is a fairly inexpensive means of treatment. In some cases, cortisone injections are prescribed or a combination of injection with splinting.

There are different types of splints available. Some block movement of the metacarpophalangeal (MCP) joint closest to the palm. Others block movement of the tip of the finger (the distal interphalangeal (DIP) joint. Some splints are custom made (designed and molded specifically to each patient) while others are premade. Ready made splints are taken off the shelf with more of a one-size-fits-all approach.

Working in a meat packing plant may make it necessary to wear gloves over the finger splint. That is to keep the splint from catching on things creating another safety threat. The splint is something that can be made specifically for you given the type of movement you need at work. A hand therapist can modify an off-the-shelf splint or make a custom-made splint for you.

Sometimes just wearing the splint (during work and leisure hours) is enough to clear up the problem. Experts in the area of hand function and disease believe that resting the soft tissues of the finger give time for the trigger finger to resolve on its own. By changing the way the tendons pull around the joints, there is less inflammation and a chance for the tendon sheath to heal and recover fully.

But if conservative care doesn't change anything for you (or not enough to make a difference at work), then surgery may be an option. The surgeon opens the pulley mechanism inside the finger that is keeping the tendon from sliding smoothly. This surgery can usually be done as an outpatient procedure, meaning you can leave the hospital the same day.

The best thing to do is see an orthopedic or hand surgeon for an evaluation and treatment. The sooner you do this, the better your chances are for recovery without surgery. Even with surgery, the procedure is simple and the results effective.

Reference: Kauser Tarbhai, BScOT, et al. Trigger Finger