Trigger Finger Release
Trigger finger is a condition in which your finger or thumb is locked in place when you bend it, creating a clicking sensation. This happens if the tendon becomes swollen and inflamed in the tunnel it runs through (the tendon sheath). This can be irritating and painful but not dangerous.
Trigger finger is also referred to as stenosing tenosynovitis or stenosing tenosynovitis. It can be experienced in both hands and may affect more than one of the fingers, usually the thumb, ring finger or little finger.
Trigger finger is most common between the ages of 55 and 60, although people of any age can develop this condition. It is seen more in women than men and people with diabetes can be more susceptible to developing the condition.
Causes of Trigger Finger
Trigger finger is caused by inflammation of the tendon that bends your finger, causing it to catch on the tendon sheath. Although it is not clear what the cause is, rigorous or repetitive physical activities that involve your fingers, or that put pressure on the palm of your hand have been linked to the development of this condition.
If you have trigger finger, the tendon sheath narrows, therefore the tendon cannot smoothly run through it. This can irritate the tendon and cause a nodule (a small lump) to form. When the nodule catches the tendon sheath, it causes the clicking or popping sensation when you move your finger.
Trigger finger is more common in people with certain health conditions, including:
- Inflammatory conditions, such as rheumatoid arthritis
- An underactive thyroid gland (hypothyroidism)
Instead of a smooth closure, the finger pauses, then snaps closed causing a ‘trigger’ effect with the same happening when the finger is stretched. In extreme cases, people must manually bring the affected finger into full extension due to the stiffness and pain they experience. Symptoms of trigger finger can include the following:
- A painful catching or popping feeling when you bend and straighten your finger
- Your finger getting stuck in a bent position
- A sore lump (nodule) in your palm at the base of the affected finger
- Stiffness in your finger or thumb
Trigger finger symptoms will tend to develop over weeks and months. Symptoms will often start out mild and progressively become more severe. Pain is often worse:
- In the morning
- When trying to straighten the finger or thumb
- When grasping something firmly
Diagnosing Trigger Finger
Your doctor will ask about your symptoms and examine your hand. They may also ask you about your medical history, and whether there is anything in particular that could have set off your symptoms such as repeated stress on your finger. It is important that you provide as much information as possible, such as when you first noticed the pain, along with the sequence of events leading up to, during and after the condition developed.
You will likely undergo a physical examination where the doctor will feel the affected finger to see if there is a nodule or any sensitivity in your palm at the base of the finger. They may ask you to bend and straighten your fingers, while they feel the palm of your hand. This may allow them to feel the catching of the tendon. Usually there is no need to have any tests however, if your doctor notices anything irregular you will be referred for further examinations such as an ultrasound scan.
Your doctor may advise you to rest your hand, and try to temporarily avoid any activities that make it worse. If you have slight symptoms, you might find that they disappear on their own within a few weeks.
If the problem doesn’t go away after a few weeks, you may want to contemplate treatment. There are a number of options to consider if your trigger finger does continue. These include painkillers, splinting, steroid injections and surgery.
Splinting and pain relief
Your doctor may recommend that you try a combination of splinting and pain relief for four to six weeks to see if this helps. You can have a splint fitted for you to put on your finger or thumb at night to keep it straight and prevent it moving. You can also take anti-inflammatory medication, such as ibuprofen to help reduce pain and swelling in your finger or thumb.
If splinting does not help or feel like the best option for you, your doctor may offer you a Cortisone (steroid) injection. The steroid will be injected into the inflamed area of your tendon sheath; you may see an improvement a few days after the injection, but it can take a week or two before you notice any substantial difference. You may also experience some pain in your hand for a day or two after the injection.
Steroid injections do not work for everyone. If there is no improvement in your symptoms after having a steroid injection, you may be offered a small operation to treat your trigger finger.
Surgery for trigger finger is called ‘Trigger Finger Release’. You will usually only be offered surgery if all other types of treatment haven’t worked, or if your finger is permanently locked.
The aim of surgery is to ease the restriction in the tendon sheath, allowing your finger to move normally again, along with stopping any pain. You will usually be able to have the surgery as a day-case procedure, meaning you will not have to stay in hospital overnight.
Nearly all patients recover completely after treatment and the tendon again glides easily through the tendon sheath without pain and without any clicking sensations. The length of recovery usually depends on the severity of your condition, along with your choice of treatment. Most people usually recover within 2-4 weeks by resting the finger and using anti-inflammatory medication, although some patients will need to wear a splint for up to 6 weeks.
If you experienced a significant amount of stiffness in your finger before surgery, you will likely be required to undergo physiotherapy in order to help loosen up the joint. A full recovery may take a matter of weeks, swelling and stiffness can remain for up to 6 months.
You can use your private medical insurance or pay for your Trigger Finger Release treatment. We offer competitive, fixed price packages as well as the ability to spread your cost with the option of 0% finance. If you are using your health insurance, please contact your insurer first for approval and let them know you’d like to be treated at either the One Ashford Hospital or One Hatfield Hospital.
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- Modern purpose-built hospital opened in March 2016 (Ashford) December 2017 (Hatfield)
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Mr Justin S Chatterjee
Consultant Plastic, Reconstructive Breast and Hand Surgeon
One Hatfield Hospital
Mr Rajeev Sharma
Consultant Orthopaedic Surgeon - Upper Limb Surgery (Shoulder, Elbow, Wrist and Hand)
One Hatfield Hospital