Trigger Thumb
Trigger Thumb is a form of tenosynovitis which occurs in the flexor tendon of the thumb. The thickening of the tendon causes it to get stuck and hold the thumb in a flexed position.
Symptoms of Trigger Thumb
- Pain at the base of the thumb.
- The thumb may be stiff in the mornings.
- The thumb gets stuck in a bent position.
- Tender to touch the base of the thumb on the palm side.
- There may be a lump known as a nodule at the base of the thumb.
Causes
Trigger thumb is a tenosynovitis of the flexor tendon in the thumb. This is a painful inflammatory condition which results in the tendon thickening and often developing a nodule (lump). The tendon usually glides through a tunnel on the palm side of the thumb, formed by the overlying fibrous bands. If the tendon is thickened, it can become trapped and so doesn't slide up and down as smoothly, resulting in the thumb being stuck in a bent position.
It is not known exactly what causes trigger thumb (and trigger finger) although repetitive movements and prolonged gripping may contribute to its development.
People with the following conditions may also be more likely to suffer from trigger thumb:
- Previous thumb injuries.
- Carpal tunnel syndrome.
- De Quervains tenosynovitis.
- Diabetes.
- Underactive thyroid.
- Gout.
- Dupuytren's contracture.
Treatment of Trigger Thumb
- It is usually clear that a patient has trigger thumb from examination.
- Occasionally an MRI scan may be used to confirm the diagnosis.
- Surgery is the most common form of treatment for trigger thumb.
- Conservative treatment may be effective in minor or early cases.
- This may include rest, ice, anti-inflammatories, a splint and sometimes a corticosteroid injection.
- Surgery involves releasing the fibrous bands which cover the tendon, allowing more space for it to move.
- Rehabiltation following surgery can be started very early to avoid stiffness.
- This may include using hand putty and therapy balls to regain full movement, dexterity and strength.
