Hand Conditions

Trigger Fingers

Definition:

Stenosing tenosynovitis (inflammation) on the volar (palm) aspect of the hand that results in entrapment (stenosis) of the tendon within the tendon sheath/A1 pulley. Any finger, or multiple fingers, may be affected at the same time.

Symptoms:

  • Pain, locking, catching or popping of one or more fingers across the metacarpophalangeal joint (joint at the base of finger). The tendon may catch or lock as it tries to extend, often requiring use of the other hand to help open the finger.
  • A tender palpable nodule (bump) may be felt on the palm side of the hand just below the joint.

Causes:

  • Trigger finger is typically caused by repetitive trauma or use of the fingers, strong grasping, diabetes, or arthritis.

Pathology:

  • Possible size discrepancy between the flexor tendon and the tendon sheath/A1 pulley creating entrapment (stenosis) of the tendon.
  • Pathological changes in the A1 pulley/sheath (degeneration/wear-and-tear and hypertrophy/swelling)
  • Associated with carpal tunnel syndrome, diabetes, hypothyroidism and rheumatoid arthritis.

Treatment:

Non-surgical

  • Rest, activity modifications, night splint, ice and NSAIDs (ibuprofen)
  • Corticosteroid injection (performed at the office); see instructions

Surgical

  • The A1 pulley/sheath is incised (released). Indicated when non-operative treatment fails.
  • See Post-op Trigger Finger Release for information on surgical recovery.

After Injection:

  • You will have numbness and pain in the finger for up to1 week after injection
  • Typically, 5-7 days after injection, the triggering and pain will begin to resolve.
  • Injections usually last 3-6 months, and sometimes are a permanent cure for trigger fingers.