Trigger Finger

Trigger ThumbWhat is a trigger finger?
Tendons are like long cables that connect the muscles of the forearm to the bones of the fingers. Pulleys are loops of tissue that hold the tendon close to the bone. A finger or thumb triggers when there is a swelling in the tendon that prevents it from gliding smoothly through the tendon pulley. Triggering results in a catching sensation when you attempt to bend or straighten the finger. Often the symptoms are worse in the morning, and symptoms may be absent for periods of time.

What causes a trigger finger?
Triggering is caused by swelling that result in a lump in the tendon. It is often the result of inflammation, but the cause is not always clear.

Trigger FingerHow is trigger finger diagnosed?
The diagnosis is easily established by history and physical examination. Often the pain is in the finger, however the triggering occurs in the palm. A lump may be felt in the tendon.

How are trigger fingers treated?
The treatment of trigger fingers is aimed at reducing inflammation in the tendon. Reducing the inflammation and swelling may relieve the triggering. The wearing of a splint or taking anti-inflammatory medication may be recommended. Injection of steroid around the tendon is successful in eliminating triggering in 80% of patients. These treatments are less successful in patients with Diabetes Mellitus.

If non-surgical treatment fails to improve your symptoms, your Doctor may recommend surgery. The goal of surgery is to release the first pulley of the tendon sheath so the tendon may glide more freely. This surgery is performed on an outpatient basis under local anesthesia, and it is very effective. Normal use of the hand may be resumed as soon as the incision pain resolves. Occasionally some patients have more pain and swelling than others, and hand therapy may be required to help resolve this.