Trigger Finger

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What is it?

Trigger finger is a painful condition in which a finger or thumb clicks or locks as it is bent towards the palm.


What is the cause?

Thickening of the mouth of a tendon tunnel leads to roughness of the tendon surface, and the tendon then catches in the tunnel. People with diabetes are prone to triggering, but most trigger digits occur in people without diabetes. Occasionally, an injury to the hand can predispose one to triggering. There is no evidence for triggering to be caused by work, but some jobs and tasks may aggravate it. Sometimes, Nodules in the tendon can predispose to triggering as in Rheumatoid arthritis.


What are the symptoms?

Pain at the site of triggering in the palm (fingers)? Tenderness if you press on the site of pain in the palm at the base of the finger.

Clicking of the finger during movement, or locking in a bent position, which can be worse in the morning.

The digit may need to be straightened with pressure from the opposite hand.  


What is the treatment?

The options for treatment are:

Using a small splint to hold the finger or thumb straight at night.

Steroid injection relieves the pain and triggering in about 70% of cases, but the success rate is lower in people with diabetes. The injection typically takes 6-12 weeks to be effective.

Trigger finger release with a needle. Some surgeons prefer to release the tight mouth of the tunnel using a needle inserted under a local anaesthetic.

Surgical release of the tunnel. This can be elegantly done under a local anaesthetic as a day/outpatient procedure. The wound will require a small dressing for 7-10 days, but light use of the hand is possible from the day of surgery and active use of the digit will aid the recovery of movement. Although the scar may be red and tender for several weeks, it is seldom troublesome in the longer term. Recurrence of triggering after surgery is uncommon.

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