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.
Causes and risk factors
- Trigger finger is most common in women
- Certain medical conditions such as diabetes mellitus, hypothyroidism and rheumatoid arthritis
- Overuse, such as repetitive gripping
- On occasions traumatic injuries may lead to trigger finger
- Tender lump in the hand
- Popping and catching in the finger joints
- Pain when extending or bending the finger
- Stiffness in the fingers after prolonged inactivity, like sleeping
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.
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.