Trigger Finger/Thumb
Trigger finger is a condition that causes the finger to ‘catch’ or ‘click’ or ‘trigger’ when it is bent and straightened. It can affect more than one finger, and when it involves the thumb, it is known as trigger thumb.
The flexor tendons (the ropes that bend your fingers and thumb) pass through narrow tunnels in the palm and fingers known as pulleys. Occasionally the tendons or tunnels become thickened. When thickening occurs, the finger begins to catch. With further thickening it may become stuck bent into the palm.
Symptoms of trigger finger can include pain at the base of the affected finger or thumb when you move it or press on it, and stiffness or clicking when you move the affected finger or thumb, particularly first thing in the morning.
If the condition gets worse, you may have pain in your hand even when it’s still. You might also get a nodule in your palm and your finger may get stuck in a bent position and then suddenly pop straight. Eventually, it may not fully bend or straighten.
The exact reason why these problems occur is not known, but several factors may increase the likelihood of trigger finger developing. For example, it’s more common in women, people over 40 years old, those with certain medical conditions such as diabetes and rheumatoid arthritis and those with occupations that require repetitive gripping movements.
In some people, trigger finger may get better without treatment.
If treatment is necessary, several options are available, including:
- Rest – avoiding certain activities
- Medication – taking non-steroidal anti-inflammatory drugs (NSAIDs) may help relieve pain and inflammation
- Steroid injection
- Surgery
Injections
A steroid (cortisone) injection into the base of the finger or thumb is preferred by lots of patients as the first-line treatment. It is usually combined with a local anaesthetic (Lidocaine) and the procedure is performed by the clinician in the outpatient clinic. The steroid reduces inflammation. It can resolve pain and triggering in the majority of patients. It is less effective in diabetic patients, those with multiple trigger fingers, and severe cases with long-standing symptoms. The procedure can be repeated, although are less effective with each subsequent injection.
Surgery
Surgery is offered if non-operative methods have not worked. Treatment can improve your hand function and resolve the pain and catching whilst bending and straightening the fingers. It is generally safe but complications, though uncommon, can happen