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Trigger finger

Trigger finger occurs when the flexor tendon becomes irritated and begins to thicken, eventually creating nodules making it difficult for the joint to bend and straighten. When the tendon is lengthening, it becomes momentarily stuck then quickly pops out into extension.

Trigger Finger Causes and risk factors

  • Gender: Trigger finger is more common in women compared to men.
  • Medical conditions: Certain medical conditions can increase the likelihood of developing trigger finger. These include:
    • Diabetes mellitus: Individuals with diabetes have an increased risk of developing trigger finger. The high blood sugar levels associated with diabetes can affect the tendons and contribute to inflammation.
    • Hypothyroidism: Hypothyroidism, a condition characterized by an underactive thyroid gland, can also be a risk factor for trigger finger.
    • Rheumatoid arthritis: Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation in the joints.
  • Overuse and repetitive gripping: Overuse of the fingers or repetitive gripping actions can strain the tendons, leading to trigger finger. This is often seen in individuals who engage in occupations or activities that involve repetitive hand movements, such as gripping tools or playing certain musical instruments.
  • Traumatic injuries: While less common than other causes, traumatic injuries to the fingers or hand can lead to trigger finger. In some cases, a direct blow or impact to the finger can damage the tendons or surrounding structures, causing inflammation and triggering the condition.

Symptoms of Trigger Finger

  • Swelling: The affected finger or thumb may exhibit swelling due to inflammation in the tendon sheath.
  • Tender lump in the hand: A small, tender nodule or lump may develop in the palm or finger where the tendon is affected.
  • Popping and catching in the finger joints: Movement of the finger may result in a popping or catching sensation, often accompanied by a clicking sound.
  • Pain when extending or bending the finger: Pain or discomfort is typically experienced when attempting to straighten or bend the affected finger.
  • Stiffness in the fingers after prolonged inactivity, like sleeping: Upon waking up or after a period of rest, the affected finger or fingers may feel stiff and require some effort to regain full mobility.

Preventing trigger finger

Occupations, sports, and hobbies with repetitive gripping can be a cause of trigger finger. The best way to prevent trigger finger or trigger thumb is to take rest breaks, do gentle stretching and strengthening exercises of the wrist and fingers, and be sure to use the correct tools for the job.

Trigger Finger Diagnosis and treatment

If symptoms are mild and generally pain free, your doctor may suggest resting the finger and/or placing it in a custom splint. Initial home treatment involves anti-inflammatory medications, massage, heat and working on range of motion of the digit. If symptoms persist, most commonly your doctor will recommend a steroid injection.

If the symptoms do not resolve, surgery may be an option to relieve pain and restore function. For most patients, this can be done in an office-based procedure room with the patient awake. This eliminates the need for anesthesiology and is less costly for the patient.

An orthopedic hand surgeon will numb the hand in the area of the trigger finger or thumb and then move the patient to a procedure room. The incision is made in the palm and is typically an inch long or less. The surgeon will remove the tissue that is causing the finger to catch or lock. After that, the patient will move the finger several times to ensure that the finger is gliding smoothly through the tunnel. The incision is closed with 2-3 stitches in the palm. A soft dressing is then applied and the patient can leave the office. Recovering from the trigger finger surgery includes range of motion exercises and normal activities of daily living. In 10-14 days the patient returns for a follow-up visit.

Nearly all patients get relief from the locking and catching symptoms after surgery. The recurrence rate for patients that have had surgery is very low.