Trigger Finger is a form of tenosynovitis which results in your finger becoming bent towards the palm of your hand. It can also occur in the thumb, known as trigger thumb.
Symptoms of trigger finger include:
- Your fingertip will be constantly bent at rest and the patient will have difficulty straightening it
- Pain at the base of the affected finger, on the palm side
- Your finger will be stiffer and more painful in the mornings
- There may be tenderness when touching the area and a lump called a nodule may be felt at the base of your finger
- Diagnosis can usually be made via observation of the symptoms. However, in some cases, an MRI scan may be used
What is trigger finger?
Mr Elliot Sorene MBBS FRCS (Tr & Orth) EDHS Consultant Orthopaedic, Hand & Upper Limb Surgeon explains Trigger finger.
Triggering of fingers (and thumbs) is associated with competitive sports. In particular, golfers and tennis players seem more susceptible.
However, these days is it particularly common for young people to play game consoles, texting and has been termed ‘Blackberry thumb’.
Tenosynovitis is an inflammatory condition of the sheath that surrounds a tendon. As the tendon passes through the wrist into the hand through a channel or tunnel there are rings which hold it in place. When the ring becomes tight and inflamed the tendon cannot pass through it properly.
This causes the finger to curl inwards towards the palm and the tendon may also click as it moves. The condition is usually worse in the morning with the finger stuck down into the hand and extremely difficult to release. It can also be associated with diabetes or rheumatoid arthritis as well as being an overuse injury and has also been known to come on for no apparent reason at all.
What causes trigger finger?
Whilst there is no specific cause there are a number of factors which may make an individual more prone to developing the condition:
- Females over the age of 40.
- Previous injuries to the finger.
- Repetitive movements of the hands or long periods of gripping.
- Those with rheumatoid arthritis are more at risk.
- Carpal tunnel syndrome.
- De Quervain’s tenosynovitis.
- Dupuytren’s contracture.
- Underactive thyroid.
Trigger finger treatment
Treatment initially is conservative in approach. This means without surgery and includes rest, ice, anti-inflammatory medication and finger splints.
If this is not successful and the condition really is bad then a corticosteroid injection is considered. In the vast majority of patients, this is successful if only for a period of time when the condition will return. Too much steroid can damage a tendon so doctors will only inject a tendon once and once only.
If the trigger finger has recurred or the injection was not successful in the first place then surgery consisting of an open release is performed. It is a small operation that can be done under local anaesthetic or general anaesthetic which means the patient can be in and out of a hospital in a day, although a window of a couple of weeks off work is required to allow time to heal. However, immediately after the wound has healed the patient can get back to keyboard activity and normal activities.
It is usually possible to move the finger quite soon after surgery. This helps to prevent it from being stiff. Rehabilitation involving hand exercises using putty and therapy balls helps maintain full strength and movement.
Surgery involves a release of the tendon. This means the tissues over the top of the tendon, which form a tunnel through which the tendon passes, are cut to allow the tendon to move more freely.