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Fernandez Upper Extremity Institute | Trigger Finger

Do you have pain in your fingers associated with a catch or “click”? Are your symptoms worse in the morning and improve as the day progresses? If so, you may have a condition called stenosing tenosynovitis, better known as trigger finger.

What are the symptoms associated with trigger finger?

Often individuals will notice that they have a painless catching or clicking in their finger when they bend and straighten it. This can progress to pain in the finger and palm associated with the clicking, or triggering. Symptoms are typically worse in the morning and improve as the day progresses with increased use of the hand. As symptoms become more severe, they can lead to a locked digit and inability to flex and extend the finger.

swollen tendon

What are the main causes of trigger finger?

o you have pain in your fingers associated with a catch or “click”? Are your symptoms worse in the morning and improve as the day progresses? If so, you may have a condition called stenosing tenosynovitis, better known as trigger finger.

Most of the time the cause is unknown. However, trigger finger can be associated with diabetes, rheumatoid arthritis, gout, or amyloidosis. It commonly occurs during the 5th to 6th decade of life and it is more common in women than men. The underlying pathology consists of a thickening of the flexor tendon, which bends the finger, and the tunnel system in which the tendon travels. As the space within the tunnel narrows, it makes it more difficult for the tendon to enter and exit the tunnel system. This causes the mechanical symptoms known as “triggering”.

DR. CARMELLA FERNANDEZ

What are the treatment options for trigger finger?

There are both non-operative and operative treatment options for trigger finger. If someone presents early in the disease process, the symptoms can sometimes be abated by taking oral anti-inflammatory medications. However, the mainstay of conservative treatment typically consists of a corticosteroid injection around the start of the tunnel system in the palm of the hand. Occasionally, more than one injection is necessary to obtain resolution of the symptoms. Unfortunately, the injections are not as efficacious in diabetic patients. If a trigger finger is not responsive to conservative treatment with injections, then surgical intervention can definitively resolve the triggering.

What does surgery for a trigger finger entail?

The surgery for a trigger finger can be performed in a surgery center under minimal anesthesia. Through a one centimeter incision in the palm of the hand, the beginning of the tunnel system is enlarged to allow the tendon to successfully pass through it. The triggering resolves immediately following the surgery and is a very successful and reproducible procedure.

If you or someone you know may be affected by trigger finger or trigger thumb, please do not hesitate to call for an evaluation.

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