Trigger Finger

A trigger finger or thumb is a common and treatable hand condition. Trigger finger affects your ability to easily and straighten your fingers easily. Patients can experience pain, locking, catching, swelling, and/or stiffness when they have trigger finger. It is common for stiffness and locking to worsen in the morning or after periods of inactivity. A medical provider can diagnose trigger finger through examination and talking about your symptoms. No tests or imaging are needed.

Anatomy

All of the fingers in our hands have flexor tendons that allow our fingers to bend. These flexor tendons pass through a tendon sheath that acts like a tunnel. When the tendon sheath or “tunnel” becomes inflamed, it is harder for the tendon to pass through. Over time the tendon can develop a nodule due to repetitive resistance. When the nodule passes through the tunnel, there is a sensation of catching or popping.

Causes

Trigger finger is more common in patients with certain medical conditions like diabetes, rheumatoid arthritis, and gout. Repetitive movements and strong gripping may also lead to the condition.

Nonsurgical Treatment

There are several nonsurgical measures to help address your trigger finger.
Rest and avoiding repetitive activities that cause triggering
Gentle stretching exercise that focuses on maintaining range of motion
Over-the-counter medications such as acetaminophen and NSAIDS
Steroid injections into the tendon sheath. This may resolve triggering for a short or extended period of time. If the triggering returns, then a repeat injection may be indicated. Steroid injections can cause a short-term elevation in blood sugar which should be closely monitored in diabetic patients.

Surgery

If nonsurgical treatment does not alleviate the triggering finger, surgery is an option. The surgery involves releasing the tendon sheath through a small incision, this is called “tenolysis”. Once the tendon sheath has been released, the tendon should be able to glide smoothly. This is an elective surgery performed in an outpatient setting. The goal of the surgery is to improve the function of your finger and decrease pain.