Trigger Finger

What is it?

Trigger finger, or tendonitis is a condition that results from thickening of the tendon in your palm which affects your fingers or thumb. It can often be alleviated with non-surgical treatment, though sometimes surgery is necessary. Tendons are rope-like structures that attach muscle to bone and allow you to bend your joints. This thickening results in pain and/or difficulty bending or straightening the finger or thumb. The symptoms include locking or clicking, pain, and stiffness (or any combination of these.) Occasionally, there is an actual lump in the palm that moves when you bend the finger. Trigger finger can be worse with heavy use of the hand or sometimes in the morning.

What Causes itr?

The symptoms are often seen in people who use their hands and fingers extensively. Needle work, heavy computer use, and other forceful, repetitious activities may also cause trigger finger. Trigger finger is commonly associated with diabetes, arthritis, and carpal tunnel syndrome. People may recall an injury to the hand, but usually there is no clear inciting event.

How is it diagnosed?

Trigger finger or trigger thumb is diagnosed by an examination by your physician. The location of the pain and swelling over the tendon below the affected digit in the palm is characteristic of trigger finger. Some patients may experience a ‘click’ or stiffness in the finger itself, the joints, or even at the tip of the finger or thumb.[

What are the symptoms?

A history of pain in the thumb side of the wrist is consistent with DeQuervain’s tendonitis. Diagnosis is confirmed by examination. This is done by forcefully moving the patient’s wrist and thumb from side to side. X-rays and other special tests like an MRI are not usually necessary for diagnosis of tendonitis, but may be used to exclude other conditions, such as arthritis or a fracture

What are the treatments?

Trigger finger is often successfully treated with a cortisone injection into the area adjacent to the tendon. The application of ice several times a day after the injection is also an important part of trigger finger treatment. If the injection is not effective or the symptoms recur, trigger finger surgery may be recommended.
Trigger finger surgery is also known as trigger finger release. It is performed through a small incision in the palm of your hand at the base of the affected digit. The sheath around the tendon is opened to enlarge the space for the tendon and the small incision is usually closed with only one small suture.

Drs. Helgemo & Olarte usually perform trigger finger surgical procedures in the office. The safety and efficacy of the procedure itself are enhanced by performing the trigger finger release in the office under local anesthesia. In many cases, the results are immediately apparent – your finger clicks, and in a few minutes the clicking is gone. The time spent at the office is trivial compared with time spent when this is performed in the operating room. An additional advantage is that the cost of conducting this trigger finger treatment in the office is significantly less than when performed in the hospital.

What are the results of the surgery?

After trigger finger release, the increased space around the tendon allows the swelling to resolve and the pain and clicking should be relieved. Prescription pain medication is not needed. Normal activities, except those that require forceful gripping, lifting, or repetition can be resumed immediately. At about a week after surgery you will be seen by one of our clinical staff or a hand therapist in your area to remove the single suture and provide instruction for rehabilitation and post-surgical use.
Complications with trigger finger surgery are very uncommon and include infection, scar tenderness, stiffness, and pain. Recurrence of the trigger is highly unlikely, but, like any surgical procedure, is possible.