Trigger finger is typically a chronic condition which interferes with normal finger movement. Tendons in your fingers glide through tunnels of fibers which allow the fingers to flex into a fist. Occasionally one of these tunnels, or the tendon itself, becomes inflamed. This impairs the tendon’s ability to flex the fingers. Depending on the severity and length of injury, trigger finger surgery may not be needed to treat this condition.
Patients with a trigger finger often experience a popping or clicking noise as the fingers are flexed or extended. Patients may get the sensation of the tendon catching as they bend or straighten the finger. This is often very painful, and patients may have to actually force the hand open to straighten the finger. The presence of a lump in the palm just below the finger can also be indicative of a trigger finger. Symptoms of a trigger finger are most common in the morning, and oftentimes resolve or decrease over the course of the day.
The hands have flexor tendons that allow the fingers to bend. These tendons pass through several fibrous tunnels that keep the tendons close to the bone. One of these tunnels can become narrowed, which causes the tendon to become inflamed due to friction. The most common site of narrowing is in the palm, which tends to be the site of a bump or inflammation. The catching and clicking noises are due to the tendon moving past this narrowed tunnel.
A trigger finger that is recognized early can be treated non-surgically with splinting and activity modification. We frequently inject trigger fingers with a steroid medication to decrease the inflammation and friction between the tendon and the pulley. If these modalities fail, trigger finger surgery is predictable and reliable. The offending pulley is simply released to allow more space for the flexor tendon to glide, which reduces the inflammation and alleviates the catching sensation.
After trigger finger surgery, a soft dressing covers the hand for 3 days. After this, a band aid is all that is needed to cover the wound. Patients come back to clinic after two weeks to have their stitches removed. At this point, daily activities and motion are determined by pain level while still protecting the healing skin. Patients feel mostly better after 4 weeks. Occasionally a patient will require physical therapy to help with pain or inflammation, but most patients do not require a formal physical therapy protocol.