Trigger Finger

Your hands, fingers and wrists are essential tools that allow you to work, play and perform everyday activities. How well hands, fingers or wrists interact depends on the integrity and function of the ligaments, tendons, muscles, joints and bones.

Problems in any of these can affect upper extremity function, causing disruptions at home and work and negatively impacting quality of life.

The human hand itself is very complex and delicate in structure. Again, this whole region works as a single unit, and the dysfunction of a single part needs consideration of the whole. An additional year of training is required for those orthopaedic surgeons seeking certification in hand and wrist surgery.

At some time in life, you may experience hand, finger or wrist pain.

Trigger finger limits finger movement. When you try to straighten your finger, it will lock or catch before popping out straight.

Trigger finger is a condition that affects the tendons in your fingers or thumb.

Cause

The cause of trigger finger is usually unknown. There are factors that put people at greater risk for developing it.

  • Trigger fingers are more common in women than men.
  • They occur most frequently in people who are between the ages of 40 and 60 years of age.
  • Trigger fingers are more common in people with certain medical problems, such as diabetes and rheumatoid arthritis.
  • Trigger fingers may occur after activities that strain the hand.

Symptoms

Symptoms of trigger finger usually start without any injury, although they may follow a period of heavy hand use. Symptoms may include:

  • A tender lump in your palm
  • Swelling
  • Catching or popping sensation in your finger or thumb joints
  • Pain when bending or straightening your finger
  • Stiffness and catching tend to be worse after inactivity, such as when you wake in the morning. Your fingers will often loosen up as you move them.

Sometimes, when the tendon breaks free, it may feel like your finger joint is dislocating.

In severe cases of trigger finger, the finger cannot be straightened, even with help. Sometimes, one or more fingers are affected.WBJ_IMG_5465 copy

Diagnosis

Your Wisconsin Bone & Joint doctor can diagnose the problem by talking with you and examining your hand. No other testing or x-rays are usually needed to diagnose trigger finger.

Treatment

Nonsurgical Treatment

Rest
If symptoms are mild, resting the finger may be enough to resolve the problem. Your doctor may recommend a splint to keep your finger in a neutral, resting position.

Medications
Over-the-counter pain medications, such as non-steroidal anti-inflammatory medicines (NSAIDS) or acetaminophen can be used to relieve the pain.

Steroid Injections

Your doctor may choose to inject a corticosteroid — a powerful anti-inflammatory medication — into the tendon sheath. In some cases, this improves the problem only temporarily,and another injection is needed. If two injections fail to resolve the problem, surgery should be considered.

Injections are less likely to provide permanent relief if you have had the triggering for a long time, or if you have an associated medical problem, like diabetes.

Surgical Treatment

Trigger finger is not a dangerous condition. The decision to have surgery is a personal one, based on how severe your symptoms are and whether nonsurgical options have failed. In addition, if your finger is stuck in a bent position, your doctor may recommend surgery to prevent permanent stiffness.

Surgical Procedure
The goal of surgery is to widen the opening of the tunnel so that the tendon can slide through it more easily. This is usually done on an outpatient basis, meaning you will not need to stay overnight at the hospital.

Most people are given an injection of local anesthesia to numb the hand for the procedure.

The surgery is performed through a small incision in the palm or sometimes with the tip of a needle. The tendon sheath tunnel is cut. When it heals back together, the sheath is looser and the tendon has more room to move through it.

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