Trigger finger causes pain and difficulty with movement. It can cause your finger to get stuck in a bend position.
What is Trigger Finger?
There are several tendons that move each finger. Tendons that bend you fingers are called flexor tendons. These tendons pass through pass through a protective tunnel, or pulley, system. This tunnel system keeps your flexor tendons in place and allow them to move in a predictable way when you bend your fingers. In trigger finger, these tunnels become inflamed and thickened, causing narrowing of the tunnel and making it difficult for the tendon to glide smoothly through it. This cases impingement of the flexor tendon of the the affected finger leading to catching or locking of your finger.
The exact cause of trigger finger is often not known. Trigger fingers most commonly occur in healthy patients with an otherwise normal hand (primary trigger finger). In some cases trigger finger, can be caused by secondary causes, such as diabetes, gout, renal disease, rheumatoid arthritis or other inflammatory conditions (secondary trigger finger).
Trigger Finger Treatment
Many trigger fingers can treated without surgery. Treatment options for trigger finger include:
Rest and activity modification:
Avoid activities that aggravate your trigger finger.
Splinting:
Wearing a splint to immobilise your affected finger can provide rest and support to the tendon. You will need to see a hand therapist to make a splint for you.
Corticosteroid injections:
If you have primary trigger finger, a corticosteroid injection may be effective at treating your symptoms. The success rate is about 60-70%. If you have secondary trigger finger, i.e. if your trigger finger is cause by diabetes or other conditions, the success rate is lower at 40-50%.
Endoscopic Release
In endoscopic (keyhole) carpal tunnel release, a small incision is made at the wrist level. It tends to heal relatively fast.
Keyhole Release
Through a small incision a specialised camera is used to release the carpal tunnel.
Open Carpal Tunnel Release
In open carpal tunnel release, an incision is made in your palm and the compressed media nerve is released.
What are the symptoms of trigger finger?
The first symptom of trigger finger is usually pain, followed by finger stiffness. You may not feel actually triggering or popping of your finger early on as this may develop over time. These early mechanical symptoms can progress to true locking of your finger, when your finger is stuck in a bend position and you need to straighten it by using your other hand. It is rare for your finger to lock in a straight position with trigger finger. General symptoms of trigger finger are:
- Pain or discomfort when bending or straightening the finger.
- Finger stiffness, especially in the morning or after periods of inactivity.
- A painful bump at the base of the affected finger. You may feel this bump become more prominent when you move your finger.
- Locking of your finger in a bent position and sudden release or triggering with a snapping sensation.
Which fingers can be involved?
The thumb is most commonly affected by triggering, followed by the ring finger, middle finger, little finger and index finger. Triggering may afffect more than one finger. This can either happen at the same time or develop gradually over time.
Trigger Finger Surgery
Do you need surgery for trigger finger?
Surgery for trigger finger is a more definitive and effective treatment. It is generally recommended when:
- You have tried non-operative treatment, but are getting persistent triggering, pain and stiffness.
- If persistent non-operative treatment is not practical and interferes with your daily activities or work
- You have progressive symptoms. This is usually where your finger or thumb locks frequently and you need to “unlock” it.
What surgery can be done for trigger finger?
Surgery for trigger finger is done through a small incision at the base of the affected finger or thumb. The thickened and inflamed tendon sheath is released to make room for the tendon to move and glide freely again. After the procedure, you can move your finger straight away and should be able to regain most movement after two weeks after surgery.