Tag Archives: trigger finger

Is a trigger finger and swans neck deformity part of Dupuytren’s contracture?

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Dear  Dr. Herazy,

I have Dupuytrens and swans neck and trigger thumb.  Yes, I am Norwegian. 

My question is trigger thumb and swans neck a part of Dupuytren’s contracture?

Thank you

Kristina

 

Greetings Kristina,

There are many degrees of involvement of the fingers when a person has Dupuytren’s contracture; some are worse and more involved than others. 

A “trigger finger” occurs when a finger tendon stick or is caught in the tendon sheath due to sheath swelling or dryness.  Depending on the number of fingers affected, location and degree of involvement it is possible to have a trigger phenomenon of one or more fingers.  This is fairly common to happen in many cases of DC. See Trigger finger and Dupuytren’s contracture.

A “swan neck” deformity is a less common occurrence in Dupuytrens. This kind of finger deformity occurs when the cord pulls the involved finger in a state of hyperextension of the PIP joint, flexion of the DIP joint, and even sometimes an additional flexion of the metacarpophalangeal joint.  Sorry to get technical with you in this explanation but I know of no other way to explain it.   TRH

Will your Dupuytren treatment also help a trigger finger problem?

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I have both Dupuytren’s contracture and trigger fingers.  Will your treatment cover both problems?

Greetings,

I do not have an answer for you.  While the DCI treatment for Dupuytren’s contracture has had a lot of successful application for palm lumps and contracted fingers, I have not had much feedback from people how if affects a trigger finger.  I think there are elements of the DCI treatment protocol that might help the swelling and inflammation of the tendon sheaths in the palm of your hand that causes your fingers to periodically catch, called trigger finger. 

For the most part a trigger finger problem tends to be more of a nuisance to a person, but Dupuytren contracture is a much larger and more dangerous problem to the health of a hand.  I suggest that you get busy doing everything you can to help your body heal your Dupuytren disease, and see if at the same time your trigger fingers improve.   I think the most important consideration is to first get the Dupuytren under control and deal with the trigger fingers later – if they are still even a problem.  TRH

If it is not Dupuytren contracture what else could keep my finger bent down?

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Dupuytren Contracture and Similar Conditions

There are actually only a few different conditions that might be confused with Dupuytren contracture.

These are the primary hand conditions, other than Dupuytren contracture, that can prevent the finger from straightening out from a flexed position:

  1. Trigger finger – this is the sticking and sudden release of restricted flexor tendon in the sheath that also commonly as an associated aspect of  Dupuytren’s contracture
  2. Ulnar nerve injury – results in a “claw hand deformity” of the entire, due to lack of extensor muscle function
  3. Extensor tendon rupture – often associated with direct trauma or arthritis
  4. Subluxation or slipping of  extensor tendons between the knuckles associated with arthritis
  5. Ganglion cyst, or a soft-tissue mass – often presents as a small and movable nodule that is tender to palpation at the metacarpophalangeal (MCP) joint, and not as far back into the palm as Dupuytren usually is located; often seen in people younger than 50 years of age and without common risk factors for Dupuytren disease
  6. Post-traumatic or arthritic joint stiffness
  7. Sarcoma – biopsy will most likely reveal a benign etiology (e.g., lipoma, inclusion cyst).

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The major differentiation sign between these listed conditions and Dupuytren contracture is that none of them is associated with the appearance of nodule or cord development on the palmar surface of the hand.  Based on this single point of differentiation the diagnosis of Dupuytren contracture is a fairly simple and straight forward matter.  However the diagnosis can be made more complex when the person with Dupuytren contracture also has present at the same time one or more of these other conditions.

Making the differentiation between Dupuytren contracture and other hand problems easier, the following points should be kept in mind:

  1. Typically the person with Dupuytren  disease is 50 years or older
  2. The likelihood of Dupuytren disease increases when a pitting or indentation is observed over the nodule(s) or alongside the cord(s)
  3. The likelihood of Dupuytren disease increases further when the nodule or cord formation is present bilaterally.

Early treatment of a Dupuytren contracture makes for a better outcome.  Learn more about using Alternative Medicine for Dupuytren treatment on the DCI website.

>> How to start Dupuytren treatment with Alternative Medicine

>> Dupuytren Contracture Treatment – FAQs

Is it a trigger finger or Dupuytrens contracture?

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I have it bad in my hands, my fingers either draw in or lock up during use and pain is THERE … I also have lumps under my skin on my lower back, are these the same thing?

 

Greetings,

When you say you have “it bad’ in your hands, exactly what do you mean?   Do you mean that you have a problem of bad pain and finger locking?   I cannot assume that you actually have Dupuytren’s contracture unless you have formally been given a medical diagnosis.    Usually, finger locking and severe pain are not a prominent part of Dupuytren disease.   The way you describe that your  “fingers either draw in or lock up during use” makes it sound like it is an occasional event, and this is not true of Dupuytren because when your fingers are flexed with Dupuytrens they stay that way except to slowly worsen; they do not straighten beyond the point of their involuntary flexion deformity. 

What comes to mind is that you have a trigger finger in one or more fingers.  Please see this link for information comparing trigger finger and Dupuytren contracture.  

A soft lump under the skin of the lower or mid back is often lipoma.    If this is true for you needs to be determined by medical examination.    There is no association between lipomas and Dupuytren’s contracture. 

Please have a competent orthopedic doctor examine you to determine what is going on with your hand and back.   TRH           

 

 

 

Trigger Finger and Dupuytren Contracture

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How is trigger finger different from Dupuytren contracture?

As a reader of this website, you probably have a good idea about Dupuytren contracture, but not a clear idea of what is called a trigger finger.

Trigger finger defined

A trigger finger is a mildly to moderately painful condition in which any finger or thumb becomes suddenly stopped or blocked during finger movement while in a flexed or curled position.  In severe cases, the trigger finger cannot be voluntarily straightened; in less severe cases of trigger finger the locked finger can only be straightened or unlocked with deliberate effort.  The trigger finger name comes from the sudden release and snapping or popping sensation that occurs when the finger finally does straighten – much like the trigger of a gun that suddenly releases with a clicking sound.

To understand what happens when a trigger finger locks while it is flexed, it is necessary to understand a bit of hand anatomy.  Those muscles that bend and straighten the fingers are not located in the hands – they are located in the forearms.  These forearm muscles can operate the fingers because they are connected to the fingers by long tendons that extend to each fingertip.  When these tendons pass through the palm on the way to the fingers, they are encased or covered with a fibrous sheathe (like a sword is kept in a sheath).  The sheath protects the tendon, guides the tendon where it passes between bones, and keeps it lubricated to make movement smoother and easier.

A trigger finger develops when there is a narrowing or constriction in the tendon sheath and a nodule develops as a result of overuse or injury.  When the finger is flexed, causing the nodule on the tendon to pass through the narrowed part of the sheath, the nodule or thickened are will catch or resist at that same point in the flexed position that brings the narrow area and the nodule together.  The sudden snap release of the trigger finger occurs when the nodule or thickening suddenly passes the restricted portion and can again freely slide past it.

The cause of trigger finger is often related to a large sudden injury or small repeated injury or overuse of the hand, or as a result of a degenerative process as with aging or disease.

Most often a trigger finger will act up in the morning, or after a period of rest after heavy hand exertion.  The finger will suddenly catch or lock while in the flexed or bent position and then with a little effort to straighten the finger it will suddenly straighten accompanied by a clicking sensation.  A trigger finger occurs more often in the dominant use hand, since this is the one most subject to overuse and injury, and most often develops in the thumb, middle or ring finger. More than one finger can be affected at a time, as well as both hands can have a trigger finger.

Trigger finger different from Dupuytren’s contracture

Trigger finger is not the same as Dupuytren’s contracture; they are only similar in that both involve finger flexion.  Dupuytren contracture is a condition in which thickening and shortening of the connective tissue occurs in the palm of the hand,  that resemble cords and nodules, in which there is some finger flexion as a result.    Both Dupuytren contracture and trigger finger can occur at the same time in the same hand, since the soft tissue changes of the former can favor development of the later.

In the experience of DCI working with this problem since 2002, we find that many of our Dupuytren contracture treatment ideas can help to reduce or eliminate a chronic trigger finger problem.