Do your fingers get stuck in the morning? Do they hurt when you try to straighten them out? Do they click when you make a fist? Or do they just ache with use? If you answered yes to any of these questions you might have trigger finger.
What is a Trigger Finger?
The technical term for a trigger finger is focal nodular stenosing tenosynovitis, which is exactly why we simply call it trigger finger. Fundamentally, it starts as tendonitis of the flexor tendons. The flexor tendons are the tendons that bend your fingers and your thumb. From the mid part of your hand towards the tip of your fingers, the tendons are contained within a series of straps otherwise known as the pulleys. This consecutive series of pulleys forms the flexor sheath. The very first pulley is the A1 pulley, and is located just below where your fingers meet your hand. It is at this location where the tendons are most likely to swell and get stuck or “trigger”. Typically, in the beginning, there will be a sense of discomfort with repetitive gripping or strong gripping in the same area. As the condition progresses it may turn to a mechanical feel of catching or clicking, and ultimately the tendon can completely get locked. This happens when the fingers are in deep flexion or bent posture (think fist).
Doyle and Blythe have identified four annular and three cruciform pulleys in the fingers.
(Adapted from Doyle JR, Blythe W: The finger flexor tendon sheath and pulleys: anatomy and reconstruction. In AAOS Symposium on Tendon Surgery in the Hand , St. Louis, 1975, CV Mosby, pp 81–87, with permission. Redrawn by Elizabeth Martin.)
We see all types of patients with this diagnosis from teenagers to octogenarians. This can happen to people who are busy and active with their hands, and it can also happen to less hands-on people. In other words, everyone’s fair game and everyone has ten chances to get one. The good news is trigger finger is a finite condition. Simply put, it has a beginning and an end. Unlike degenerative conditions, like arthritis which will continue to progress, you can be cured of your trigger finger.
While splinting is an option in the early stages, more effective methods include steroid injection and ultimately a trigger finger release. If a diagnosis is made early in the process occasionally, a steroid injection can be a long-term cure. However, if the trigger finger is advanced or has failed a steroid injection, a trigger finger release in most cases is a definitive cure and done very simply. This is a procedure we perform in the office under local anesthetic. Recovery and return to work time after an in office local anesthetic trigger finger release depends on the nature of the work that you return to and/or what your hobbies may be. For those who work in an office environment using phones and keyboards, their return to work can be within one to three days. If your work requires heavy gripping or repetitive gripping with the hands in order to protect the small incision on the palm it’s usually closer to two weeks.
The good news about a trigger finger release is it rarely, if ever, recurs once it’s been surgically treated. If you have any questions about trigger finger diagnosis or treatment you can call us to schedule a consultation with one of our experts!