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    Dr. Belongie

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    trigger finger


    A trigger finger refers to a condition in which a finger or thumb will lock or catch when attempting to straighten it.  By definition, a tendon connects muscle to bone. Flexor tendons extend from the muscles in the wrist and attach to the fingers and thumb. Normally, when you flex and extend your fingers, the flexor tendons glide through a small tunnel known as the tendon sheath.  For various reasons, the tendon sheath can become inflamed and thickened resulting in narrowing. In this case, the flexor tendons no longer glide smoothly. The tendon can get “stuck” when trying to straighten out.

    A trigger finger is usually not caused by a specific injury. The symptoms include catching, popping, swelling, and pain in the finger or thumb. In some cases, a small nodule may develop along the palm side of the hand.  Many report increased symptoms first thing in the morning and after being inactive for a time period. As the disease progresses, inability to straighten out the finger may develop.

    The cause for development of a trigger finger is unknown. There are several risk factors that are associated with trigger fingers. Women are more likely to develop this then men.  The common age range is 40 to 60 years of age. Certain medical conditions such as diabetes and rheumatoid arthritis may also are linked to development of a trigger finger.  Repetitive finger and thumb movements may also be a risk factor.

    Trigger finger is diagnosed by physical examination. Many will present with the classic symptoms of locking and catching described above along with a nodule that can be felt. There are no imaging studies needed to diagnose this condition.

    Non-surgical treatment options include activity modification, non-steroidal anti-inflammatory medication, corticosteroid injections and splinting.

    For those who fail to improve with non-surgical treatments, surgery may be considered.

    A trigger finger release is performed on an outpatient basis using local anesthesia. The procedure involves making a tiny cut along the palm side of the hand and cutting the tendon sheath to create more room within the tunnel.

    Most patients notice immediate relief of their complaints following this type of surgery. Full recovery can take a few weeks up to a few months.  As with any procedure, complications can develop. Some may have persistent tightness or triggering as a result of incomplete release of the tendon sheath. Infection is also a risk from this type of procedure.

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