18 February 2015
Trigger finger can affect your thumb or any finger. More than one finger can be affected at the same time and the condition may develop in both hands.
Mr Adrian Chojnowski, Consultant Orthopaedic Surgeon at Spire Norwich Hospital explains: “Symptoms of trigger finger may include pain, stiffness, clicking and a small lump in the palm at the base of the affected finger or thumb (known as a nodule).
“On the palm side of the finger/thumb, at its base, the tendon enters a tunnel system (called pulleys) designed to prevent it from pulling away from the bone as the finger/thumb flexes (bowstringing).
“A layer of cells lubricate the tendon. The tunnel entrance can thicken and the synovium becomes inflamed causing tenderness and pain. The smooth glide of the tendon is disrupted causing it to judder - the digit can become locked in a bent position requiring extra effort or the other hand to straighten it - hence ‘triggering’ - and can lead to joint stiffness.
“Why it starts is unknown in the vast majority of cases and it represents a very common condition in the hand and can sometimes be associated with inflammatory conditions such as rheumatoid arthritis or diabetes.
“Occasionally trigger finger may be confused with Dupuytrens disease – a build up of scar tissue in the palm causing the fingers to pull into the palm - the fingers are always fixed and cannot be straightened. There can be other problems that affect finger tendon glide which could mimic trigger finger but these are very rare!
“Some people who develop trigger finger may get better without treatment. Allowing the hand to rest may resolve any inflammation without the need for medical intervention. Other non-invasive treatments may include using a splint. By strapping the affected finger to a plastic splint at night, so that it’s completely straight, may ease the symptoms and prevent it locking but it’s not common to use due to the relative success of local steroid injections or surgery.
“A local steroid injection over the tunnel entrance ('A1 pulley') could be tried as it can be curative or at least, generally helps. A second injection may be considered if partial or temporary response to the first. Such injections are generally useful so should be tried early.
“An operation to release the pulley (turns out you don’t need this bit of the tunnel system) under local anaesthetic can be performed as a day-case procedure. It is a quick procedure which takes around ten minutes to perform and leaves a short scar. The finger/thumb can be used straight away but a common sense approach is applied for the first few weeks i.e. avoid heavy repetitive jobs.
“Risks of surgery are small, there will be a degree of scar tenderness which usually fully settles and very small complication rate such as infection or injury to the digital nerve and vessel. The surgery is usually curative and recurrence extremely unlikely.”
For further information or to make a private appointment with Mr Adrian Chojnowski please contact one of the team on 01603 255 614 or complete the enquiry form on the right hand side of this page.
All surgery carries an element of risk and the content of this page is provided for general information only. It should not be treated as a substitute for the professional medical advice of your doctor or other healthcare professional.