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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?
You may notice a painless catching or clicking in your finger when you 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.
WHAT ARE THE MAIN CAUSES OF 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”.
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 are experiencing the symptoms of trigger finger, give us a call or use our online appointment request to schedule a visit with Dr. Carmela Fernandez, our upper extremity specialist.
This article and illustration are reproduced from the website of Carmela Fernandez, MD, and are used with her permission.
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