Trigger finger can leave the finger or thumb stuck in a bent or flexed position. It happens when the protective sheath covering the tendon becomes inflamed. Surgery to cut the tendon sheath can relieve pain and stiffness.
If other treatments are not successful or the condition is severe, surgery is usually successful in restoring full movement.
The recovery time for trigger finger surgery is quick, and the procedure has a high chance of success.
Trigger finger or stenosing tenosynovitis is when the finger gets stuck in a particular position at one or more of the joints.
Trigger finger can make it difficult to move or use the finger; it also causes pain and discomfort.
The condition can affect any finger or the thumb and can occur in one or more fingers. Trigger finger is sometimes called trigger digit, as it can affect the thumb as well as the fingers.
Tendons connect the bones to muscles, allowing them to move. The tendons are protected by a covering called a sheath. When the tendon sheath becomes inflamed, it can make the gliding of the tendon within the sheath irregular, too tight, or incongruent, may sometimes result in trigger finger.
The symptoms of trigger finger are:
- pain at the base of the finger or thumb when it moves or is pressed on
- stiffness or a clicking sound when moving the finger or thumb
- as the condition worsens, the finger or thumb may curl and get stuck, before straightening suddenly
- loss of the ability to bend or straighten the finger or thumb
The condition can affect any digit but is most common in the fourth and fifth fingers of the hand and the thumb.
There are three types of surgery for trigger finger:
- Open surgery: A surgeon makes a small incision in the palm of the hand and then cuts the tendon sheath to give the tendon more room to move. The surgeon will use stitches to close the wound. A person will typically be given a local anesthetic so should not feel any pain.
- Percutaneous release surgery: This surgery is also done using a local anesthetic. A surgeon inserts a needle into the bottom of the digit to cut the tendon sheath. This type of surgery does not leave a wound.
- Tenosynovectomy: A doctor will only recommend this procedure if the first two options are not suitable, such as in person with rheumatoid arthritis. A tenosynovectomy involves removing part of the tendon sheath, allowing the finger to move freely again.
Open surgery has traditionally been preferred by medical professionals because it has a very low risk of complications.
There is a small chance that percutaneous release surgery may damage blood vessels or nerves close to the tendon sheath.
However, percutaneous release surgery does not leave a scar and is more cost-effective. A small 2016 study found that people had an equal level of long-term satisfaction with both open and percutaneous release surgery.
Surgery will take around 20 minutes, and a person should not have to stay in the hospital overnight. The person will remain awake during the procedure, but local anesthetic will ensure they do not feel any pain.
Surgery may initially cause some pain or soreness. Doctors may recommend over-the-counter painkillers for relief.
Immediately after surgery, a person should be able to move their finger or thumb. Be gentle with movements at first; full movement can be expected to return in 1 to 2 weeks.
People should keep a dressing on their finger for a few days following open surgery. After this, they must keep the wound clean, using mild soap and water.
If a person has stitches, a medical professional may need to remove them after 2 to 3 weeks. Dissolvable stitches will dissolve within 3 weeks.
A person should ask their doctor about when they can resume everyday activities, such as driving or using a computer. Recovery time may be longer for someone who has had trigger finger surgery on more than one finger or thumb.
Some people may need to do finger exercises or undertake hand therapy to return full movement to the affected digit.
If left untreated, trigger finger can become permanent. If the affected finger or thumb becomes stuck or fixed in a bent position, it can make day-to-day tasks more difficult.
However, trigger finger is curable without surgery in most cases. Non-surgical treatments include:
- injecting steroids into the base of the affected digit to reduce swelling
- strapping or splinting the digit to stop it moving
- taking anti-inflammatory medication
- reducing or temporarily stopping the activity that causes pain
If these treatments do not work, surgery may be needed. Before deciding on surgery, a doctor will consider how much pain a person is in, how much it affects their day-to-day activities, and how long they have been experiencing the pain.
Around 20 to 50 percent of people who have trigger finger might need surgery to correct the condition.
Trigger finger can affect children, but surgery is not usually the recommended treatment. Trigger finger in children can often be treated with stretching and splints.
All three types of trigger finger surgery are considered low risk and straightforward, so complications are unlikely.
There are some risks, and a doctor should explain these before surgery. These include:
- pain, stiffness, or reduced ability to move the digit
- nerve damage
- incomplete release, which means that the digit can move partly but not fully
Trigger finger can affect anyone, but the following groups have a higher risk of developing the condition:
- people aged 40 to 60
- people who have had a hand injury in the past
- people with rheumatoid arthritis
- people with diabetes
Repetitive movements, such as gripping a steering wheel or playing guitar, may cause trigger finger. In most cases, however, the exact cause is unknown.
Trigger finger is linked to certain medical conditions. Rheumatoid arthritis causes swollen joints and joint tissue, and this inflammation can extend to the fingers and thumbs. If the tendons in the digits become inflamed, it may cause trigger finger.
People with diabetes also have a higher risk of developing trigger finger. The condition affects 10 percent of those with diabetes, but only 2 to 3 percent of the general population. The link between diabetes and trigger finger is unclear.
Trigger finger surgery is usually effective, and the problem is unlikely to happen again after surgery.
Both the open and percutaneous release methods of surgery have a high success rate, and recovery is relatively quick.