52017Dec

How is Trigger Finger Treated?

Many people familiar with tendinitis in the shoulder or the elbow are surprised that it is the source of a condition called trigger finger.  The first step toward relief from hand pain and other symptoms linked to this disorder is a free hand screening.

Condition Overview

Patients with this condition have trouble straightening or bending a thumb or a finger.  With this disorder, officially called stenosing tenosynovitis, the digit gets stuck in a bent position, according to the Mayo Clinic

An effort to straighten or bend a finger can cause a snap that resembles pulling a trigger, then releasing it.  Fingers and thumbs of both hands might be affected.  The most common symptoms include:

  • Stiffness, especially in the morning
  • A sensation of clicking or popping when moving a finger
  • Hand pain or tenderness
  • A nodule that appears in the palm and at the base of a digit
  • Locking or catching of a bent digit

The underlying reason for the problem is a thickening of a tendon in the palm.  Trigger fingers occur when the tendon sheath of each affected digit develops irritation and inflammation.  This disrupts the normal movement of the tendon through its sheath.

Although the specific culprit in each case is usually elusive, repetitive actions such as keyboarding, needlework, and strong gripping increase risk.  Other factors that predispose a person to this disorder are being female, suffering from conditions such as rheumatoid arthritis or diabetes, or undergoing recent carpal tunnel syndrome surgery.

Treatment Options

A hand doctor’s goal in treating this condition is eliminating discomfort and facilitating full movement of any affected fingers or thumbs.  A free hand screening can detect the disorder before it becomes debilitating.

The American Society for Surgery of the Hand notes that hand doctors are able to offer a number of therapeutic options, typically on an outpatient basis, to patients with trigger fingers.  Use of night splits is effective for some individuals.  Sometimes lifestyle changes such as foregoing or modifying specific activities bring relief.  In some cases, injecting the area next to the tendon with cortisone provides a successful resolution.  Several applications of ice following an injection are part of this therapy. 

When steroid injections prove ineffective, or symptoms emerge again, a hand doctor is likely to recommend surgery.  The objective is opening a “pulley” structure at the base of the affected digit in order for the tendon to move more easily and more freely.

Hand surgeons refer to this surgery as a release.  They commonly perform it in their offices or clinics using local anesthesia.  The doctor makes a small incision in the patient’s palm at the base of the targeted finger or thumb.  The next step is opening the sheath that surrounds the tendon to give the tendon more room.  In most cases, the procedure requires only one suture and yields immediate results.