Trigger finger or trigger thumb occurs when a tendon in a finger or thumb becomes inflamed. A ligamentous strap, called a pulley, holds the tendon close to the bone similar to how a fishing line is held on a fishing rod. Locking and catching can occur when the pulley becomes too thick and the tendon develops a bump on it that prevents the tendon from gliding through the pulley smoothly.
The condition is more common in people who have diabetes, rheumatoid arthritis, or a history of repeated injury to the area. Trigger finger or trigger thumb are more commonly seen in people who have jobs, hobbies, or perform tasks that require repetitive and prolonged gripping.
Symptoms may include:
- Inability to fully flex the finger or thumb.
- Locking of the finger(s) or thumb in the bent position (in severe cases). The finger(s) or thumb must be gently straightened with the help of the other hand.
- Snapping or popping sensation when moving the finger(s) or thumb.
- Soreness at the base of the finger or thumb in the palm, especially while gripping or grasping.
- Pain and stiffness when bending the finger(s) or thumb which may be worse in the morning.
- Swelling or tender lump in the palm of the hand.
ValleyOrtho’s specialty-trained and board-certified orthopedic physicians are experienced in diagnosing conditions related to the hand, including trigger finger and trigger thumb. A thorough medical history and an exam are usually all that is needed to diagnose trigger finger. X-rays and other tests usually are not needed.
The physicians at ValleyOrtho explore all nonsurgical options before considering surgery.
The first step in treatment is to modify activities that aggravate the condition. The second step is to immobilize the affected finger or thumb, either by taping it to a neighboring finger or by using a splint. Splinting at night can be especially helpful in preventing the thumb or finger from becoming locked.
If severe locking or other symptoms still occur after conservative management, the care team at ValleyOrtho may recommend a steroid injection into the base of the affected finger or thumb
When locking and pain still persist, surgery may be an option. Surgery for trigger finger releases the pulley through which the tendon passes. This lets it glide more easily through the sheath. Surgery usually restores finger movement immediately, and patients can begin gentle range-of-motion exercises within a few days. Scar management is important following a surgical release. Hand therapy can guide a patient through the post-operative process to maximize the surgical outcome