Why is trigger finger stiff only in the morning?
Trigger finger tends to feel stiff only in the morning because blood flow decreases while you are asleep at night. During sleep, your body moves less, and some parts of your body remain pressed against the bed for long periods, so circulation becomes poorer than it is during the day.
Blood carries oxygen and nutrients to the muscles, so when circulation slows, the muscles become stiff. If your fingers are bent when you wake up in the morning, it is because the muscles have tightened and shortened, pulling on the fingers and causing them to stiffen in that position.
In other words, because trigger finger is caused by muscle tension, it can occur not only during sleep but also during the day whenever the conditions that make muscles stiff are present. For example, someone may temporarily develop trigger finger after using a shovel in a home garden, and then recover by the end of the day.
Why do the symptoms appear only in the fingers?
We now know that the muscle stiffness behind trigger finger is influenced by reduced blood flow. The key point, however, is that the problem appears only in the fingers. Everyone experiences reduced circulation at night, but in some people it shows up as lower back pain or shoulder pain, while in others it causes no symptoms at all.
So why did the symptoms appear in the fingers?
- Have been diagnosed with trigger finger or tenosynovitis
- Have trigger finger symptoms not only in the morning but also during the day
- Had surgery, but the problem has returned
The key to solving this problem is understanding your body's habits.
Understanding the cause of trigger finger is just as important as thinking about how to relieve morning finger stiffness.
People who struggle with trigger finger often have characteristic ways of using their body and problems with joint movement. By identifying these patterns, you can pinpoint the cause and see which approach will solve the problem most efficiently and directly. Let’s look at the body habits that create pain in the fingers.
Common traits among people with trigger finger
One thing many people with trigger finger have in common is that their shoulders sit forward.
The illustration checks whether there is a gap between the shoulders and the floor. Ideally, there should be no gap.
This gap is often seen not only in trigger finger, but also in people who have numbness in the fingers or weakness in the hands. When the tension is released and the gap disappears, the condition improves.
Why does a gap form between the shoulders and the floor? Because the pectoralis major, the large muscle in the chest, is stiff and tense.
Reason 1 your chest muscles are stiff: how you use your arms
There are two main reasons the pectoralis major becomes stiff. The first is the way the arms are used in a biased pattern.
In daily life, we spend a great deal of time with our arms rotated inward. When holding bicycle handlebars, gripping a pen, or using a kitchen knife, the arms are turned inward.
We rarely keep the arms turned outward. The few exceptions are things like twisting a doorknob or carrying a tray.
Because the pectoralis major has very few chances to relax, a muscle that is repeatedly kept shortened will eventually stay shortened.
Reason 2 your chest muscles are stiff: a tight abdomen
The second factor that makes the chest muscles stiff is tightness in the abdominal muscles.
The illustration checks neck movement. A normal range of motion is being able to look upward until your face is roughly parallel with the ceiling.
At that point, not only the neck itself but also tension in the abdomen can prevent you from looking up fully, and it may also cause pain in the neck and back.
Quite often, the factor limiting neck movement is not the neck at all, but the abdomen. People with trigger finger in particular often have a tight abdomen.
This is easy to miss because the abdomen is so far from the fingers. What makes a fundamental solution even harder to find is the unexpected fact that this abdominal tension is actually caused by the shoulder blades in the back.
The shoulder blades are in the back. Why would a problem there make the abdomen stiff?
It is very common for the shoulder blades to shift outward. As the body tries to bring the shoulder blades back to their original position, the muscles in the back contract (an eccentric contraction of the rhomboids and trapezius). At the same time, the serratus anterior also contracts to adapt to the reduced space.
When these back muscles are tight, movement of the rib cage becomes restricted. Eventually, the tension in the chest is transmitted to the abdomen through the intercostal nerves, which connect the chest and abdomen.
In addition, the abdominal muscles, affected by tension in the chest, become stiff and pull the chest muscles downward. As a result, a slouched posture begins to feel more comfortable.
In short, the shoulder blades in the back can make the abdomen stiff because tension in the back is transmitted through the nerves and affects the abdomen.
Treatment record
Let’s look at a treatment record to see the steps through which trigger finger improved.
- Symptoms:
① Trigger finger upon waking in the morning. Depending on how the fingertip is used, the finger may stay bent during the day as well. ② Pain in the hip joint and buttocks when sitting. - Age: 40s
- Work: Long hours of sitting
- What they had tried: seitai, stretching
If we put the events so far in chronological order, they would look like this:
- They have had stiff shoulders since their teens.
- Trigger finger started six months ago. The ring finger has consistently felt hard to move.
- More recently, they have been spending more time sitting and started to feel pain in the hip joint and the side of the buttocks.
- They tried stretching the whole body, but it did not improve
Various tests are performed to identify the cause. Each part of the body has a normal range of motion. If a part cannot move as it should, or if moving it up and down or side to side is harder on one side, that area may be contributing to the pain.
Test results
The examination showed that several areas throughout the body were not functioning properly.
We checked the neck’s range of motion.
Ideally, when looking upward, the face should come to a position parallel with the ceiling, but it stopped partway. This movement also seemed to cause pain in the neck and back. Poor movement of the chest and back is the likely cause.
When turning the head left and right, there was a catching sensation when turning to the left. One possible reason is that the left shoulder blade has shifted upward.
Next, we checked whether there were any problems with the position of the shoulder blades.
Although the symptoms are in the fingers, I do not touch the hands at the beginning, for two reasons.
① Inflammation gets worse, leading to more visits
Massage can temporarily improve blood flow, so it feels good at first. However, the muscles causing the pain are inflamed, so pressing on them only makes the inflammation worse. As a result, the pain can continue constantly, making it impossible during treatment to tell whether the symptoms are improving or not.
If that happens, it becomes impossible to judge improvement on the spot, and the outcome is often, “That’s all for today. Let’s wait and see for a while,” which leads to more visits. Increasing the burden on the client is not desirable.
② The cause is not where the pain appears
When the fingers are the problem, the real cause is often hidden far away, in the abdomen or legs. Relaxing the muscles around the hand can bring temporary relief, but it does not address the root cause.
In some cases, the painful muscles are actually muscles that should not be relaxed. If treated the wrong way, the more treatment they receive, the worse the pain becomes.
For these two reasons, even when a client complains of trigger finger, I do not begin by touching the hand.
Treatment details
Here is an introduction to the seitai treatment method.
A distinctive feature of NAKO’s treatment is that it does not aim for the kind of session where you gradually feel more comfortable, drift into a deep sleep, and wake up with the pain feeling like a distant memory.
NAKO’s treatment combines repeated examination and treatment in close cooperation with the client. The goal is to reach a solution as quickly as possible. For that reason, during the session you may repeatedly change positions, such as standing and sitting, while being re-examined, and you may also do light exercises to help align the body. So there may not be much time to simply lie back and relax.
NAKO’s method began through trial and error in overseas settings where the available stay was limited, with the question of how quickly pain could be relieved. Since we never knew when we would meet the client again, we kept researching ways to find a solution on the spot. As a result, we now provide a unique style of treatment that incorporates examination and exercise.
We repeated the movements that had caused pain during the pre-treatment examination and found that there was no longer any hip pain, even while sitting.
Since trigger finger can only really be judged the following morning, it could not be confirmed on the spot, but later it was found that the symptoms had not returned.
It may heal naturally. If the condition worsens, it will progress to the next stage, depending on the progression of the trigger finger.
① I have pain at the base of my fingers. My hands are swollen when I wake up in the morning.
② The base of the finger is swollen or feels hot. It is difficult to move.
③My finger is bent and won't straighten.
④ Repeated recurrences.
Even if the condition heals naturally, you are still using your body in a way that makes you more susceptible to trigger finger, so it's a good idea to take this opportunity to check what parts of your body are not in ideal condition.
Steps to solving the problem through seitai
The way we use our bodies today is shaped by everything we have experienced since childhood, including play, sports, accidents, childbirth, and many other events.
If you are in pain, it is simply your body’s way of telling you that there has been a problem in how you have been using it up to now.
The first stage of recovery is to stop the pain. Once the cause has been identified through examination and treatment is given, the pain can be reduced. Only after the pain has improved are you ready to learn the correct way to use your body.
The second stage is learning the correct way to use your body. This changes both the body and the brain so that you do not return to your old condition.
Because physical pain is often caused by lifestyle habits, stretching and exercise become necessary. Just like brushing your teeth, steady consistency is important.
If you want to solve pain, the first step is to stop the pain. Stretching and exercise come after that.
