Trigger Finger

Trigger finger is a condition that occurs when the tendons in your hand become irritated or swollen.

The treatment for trigger finger is determined by the severity of your symptoms and how long you’ve been experiencing them for.

The causes for trigger finger are still unknown, and often symptoms can get better without treatment. However sometimes if the condition is left untreated, the affected finger or thumb can end up becoming permanently stuck, either in a bent, or less commonly, straightened position, making it difficult to carry out everyday tasks.

Trigger finger, in most cases, is a nuisance rather than a serious condition.

Treatment

Splinting

Strapping the affected finger or thumb to a splint can help to relieve your pain by preventing your finger from moving. Although not as effective as some other forms of treatment, using a splint overnight can reduce the stiffness that is often felt by sufferers of trigger finger in the morning.

Corticosteroid injections

Corticosteroids are medicines used to reduce swelling in trigger fingers.

Injecting liquid corticosteroids into the tendon sheath (the tunnel that the tendon slides through) at the base of your affected finger or thumb can help to reduce swelling in the tendon, allowing the tendon to move freely again.

Usually movement will not be restored until a few days or weeks after the injection has taken place. Corticosteroids injections can permanently improve trigger finger, however often the condition will recur, and tend to be less effective in people with some underlying health conditions such as rheumatoid arthritis and diabetes.

Surgery

If splinting or injections are not suitable or do not ease the symptoms, Mr Bhatia will recommend trigger finger release surgery.

Trigger finger release surgery involves cutting through the tendon sheath that attaches the tendon to the finger bone, allowing your tendon to move freely again. Surgery is the most effective treatment for trigger finger, and rarely will the condition recur once surgery has taken place.

Trigger finger release surgery typically only takes around 20 minutes to perform, and there is therefore no need to stay in hospital overnight. The procedure is performed under local anaesthetic.

There are two types of trigger finger surgery:

  • Open trigger finger release surgery
  • Percutaneous trigger finger release surgery

If you suffer from rheumatoid arthritis a special procedure called a tenosynovectomy will be recommend instead, as the above surgical techniques can cause your finger to drift sideways. Tenosynovectomy surgery involves removing part of the tendon sheath.

Open trigger finger release surgery

For patients undergoing open trigger finger release surgery, Mr Bhatia will inject a local anaesthetic into the palm of your hand, and then make a small incision along one the natural creases to help make any scar less visible. Mr Bhatia then cuts through the tendon sheath to make it wider, before closing the wound with stitches and covering with a dressing.

Percutaneous trigger finger release surgery

Percutaneous simply means ‘through the skin’. Similar to the open method of surgery, Mr Bhatia starts by injecting the patient’s hand with a local anaesthetic. However, instead of making an incision into the palm of the hand, Mr Bhatia will use a needle to slice through the ligament.

The benefit of percutaneous surgery over open surgery is there is no scar left after the procedure has been performed. However, wherever possible, Mr Bhatia will recommend open surgery, as percutaneous surgery is slightly more dangerous due to the risk of damaging the important nerves and arteries that lie very close to the tendon sheath. Open surgery also tends to be more effective at resolving the problem.

Recovery

Patients are usually able to move their finger immediately after surgery. Dressings are removed after a few days to make movement easier, and full movement in the finger should return within a week a week or two.

Open surgery may leave you palm feeling sore following the procedure, however any discomfort will subside within a couple of weeks. For patients who have undergone surgery on more than one finger, the recovery period may be longer, while patients who have undergone percutaneous surgery may experience a shorter recover period.

Following trigger finger release surgery, typically patients should be able to:

  • write and use a computer immediately.
  • start driving after 3-5 days.
  • play sports after your wound has healed, usually after 2-3 weeks.
  • return to office work immediately. If your job involves manual labour you may need up to 4 weeks off.

If you have undergone open surgery it is important that you properly care for your wound. Mr Bhatia will explain how to this to you following your surgery, and will also give you a time to return to hospital to have your stitches removed.

If your finger was stiff before surgery you may need to visit one of the hand therapists available throughout Mr Bhatia’s Bristol clinics, to help loosen it after the operation has taken place.