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‘Getting a Grip’ on Trigger Finger and Dupuytren’s Contracture

Do some of your fingers not have the same range of motion they once did? Maybe they’re beginning to curl inward a bit more. Do you feel resistance when you straighten them or struggle to grip things?

If these sound familiar, you might be experiencing either trigger finger or Dupuytren’s contracture. While they do have some similarities, each condition manifests in slightly different ways, has different things happening under the skin and requires different treatments.

Nicholas Noce, MD, an orthopedic hand surgeon at Banner Health in Northern Colorado, told us about the differences and the best course of action for people experiencing these conditions.

Signs of trigger finger and Dupuytren’s contracture

Most of the time, trigger finger shows up in the thumb and ring finger, but it can happen in the other fingers, too. When you have trigger finger, you may notice the following signs:

  • The finger struggles to bend and straighten smoothly
  • The finger feels like it’s “locked” into either a bent or straightened position.

Why does this happen? Each finger has a tendon that helps it bend toward the palm, and each of these tendons is surrounded by a sheath or protective covering. With trigger finger, the tendon becomes inflamed, its surrounding sheath swells up, and a nodule or lump forms within the tendon. This new nodule, Dr. Noce explained, then catches or sometimes locks the finger into place as it struggles against the sheath. If the tendon’s inflammation has been there for a long time, the finger can become stiff, and won’t fully flex into a fist. Trigger finger can happen from repetitive use, and be influenced by diabetes, hypothyroidism, rheumatoid arthritis and is more likely to occur in women.

Dupuytren’s contracture, meanwhile, usually happens in the ring and pinky fingers. (Though, again, it can happen in any finger.) This condition resides in the tissue right under the skin, in the palm of your hand, rather than in your finger’s tendons. Dr. Noce explained that in Dupuytren’s contracture, the tissue’s cells experience a genetic change that makes it contract. When this happens, the tissue in your palm begins to form new nodules and cords. You may experience the following symptoms:

  • Small, tender lumps in the palm of the hand
  • The finger contracts into the palm gradually — sometimes over years, sometimes over months
  • The finger can’t straighten

It’s hard to say exactly how common the disease is, but things like age (over 50), sex (male), diabetes, and tobacco/alcohol use can increase your risk. It’s more common in Caucasian people of Northern European/Scandinavian descent and is considered a genetic condition. But “just because one person has it, that doesn’t necessarily mean their parents or grandparents or children will have the same thing,” Dr. Noce assured.

How to treat trigger finger and Dupuytren’s contracture

Both conditions are diagnosed in a clinic — there aren’t any special tests or imaging required. Dr. Noce said the patient’s story and a clinical exam are the most important parts of determining the issue.

According to Dr. Noce, treatment for Dupuytren’s contracture is often successful. Treatment options include cutting the newly formed cord, surgically removing the cord or injecting into the area. After treatment, some patients may opt for additional physical therapy and/or wear a splint on the finger at night to prevent re-curling.

Trigger finger treatments also have a pretty good prognosis generally. Dr. Noce explained that treatment usually focuses on relieving inflammation, and is done through splinting, non-steroidal anti-inflammatory drugs (NSAIDs), steroid injections or minor surgery.

If you or someone you know may be experiencing either trigger finger or Dupuytren’s contracture, speak to your health care provider or find a doctor at bannerhealth.com, and “get a grip” on those pesky hand and finger problems! Learn more about hand conditions in these similar articles:

Genetics Orthopedics Pain Management Rheumatology

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