Why Some Patients Develop a Trigger Finger:
- tendons in the hand connect muscles with bones;
- these tendons slide through a tunnel called a tendon sheath;
- the tendon sheath may become irritated, which narrows the tunnel;
- when the tunnel is narrowed, it may cause the tendon to jam at a certain point;
- the jammed tendon may stay in the bent position, or it may be released with a little popping sound or pain.
What Are The Triggers?
It’s not known exactly what causes trigger finger. The syndrome is more common in women between the ages of 40 and 60, and in patients with rheumatoid arthritis or diabetes.
Straining the hand— with repetitive movements, for instance— may bring on a case of trigger finger. The deformity may heal on its own given enough time, but many patients prefer to seek treatment to relieve the nuisance factor. Without treatment, there may be pain when the trigger finger is bent or straightened, or swelling in the palm or finger. The trigger finger tends to be stiff when the patient first awakes in the morning, and then it may relax over the course of the day. In the most severe cases, the finger cannot be straightened, even with physical manipulation.
You doctor can diagnose trigger finger by examining the finger. Imaging tests (such as x-rays) are not needed.
Treatment: Conservative and Surgical Options
Treatment for trigger finger usually starts with conservative methods. The finger may be fitted with a splint to keep the tendon in a neutral position while the irritation subsides. Pain may be managed with a nonsteroidal anti-inflammatory drug (NSAID) or acetominophen.
Your doctor may recommend a cortisone injection to temporarily relieve inflammation in the tendon sheath. Usually, several injections a few weeks apart, bring relief. Patients who’ve had a trigger finger for a long time or patients with an underlying condition such as diabetes are less likely to get relief from cortisone injections.
If conservative therapies fail to correct the trigger, surgery is an option.
Surgical treatment consists of widening the tendon sheath to allow the tendon to pass easily through it. This can be done in the doctor’s office, with no need for a hospital stay. After an injection of local anesthesia, the doctor inserts a needle through the palm, or makes a small incision in the finger. Patients are usually able to move their finger immediately after surgery. It may take a few weeks or months for the swelling and stiffness to completely subside.
Why See Your Doctor About Trigger Finger
Many people don’t seek medical advice on their trigger finger until it has become a real impediment to everyday activities. This is unfortunate because treatment is most effective and healing is quicker when the condition is arrested in the early stages. While trigger finger is not dangerous, it can interfere with many routine activities— holding a hot cup of coffee, for instance, or pinning a baby’s diaper. For that reason, we encourage patients to make an appointment at our clinic while the finger is still in the ‘joke’ stage.