Trigger finger/thumb
What is it?
Trigger finger/thumb is a condition in which the finger or thumb clicks or locks as it is flexed toward the palm.
What causes this?
Tendons are the ropes that connect muscles to bones and enable joints to move. The muscles that move the fingers and thumb are within the forearm and have long tendons that connect to the fingers and thumb. These tendons have pulleys that form a tunnel from the palm to the end of the finger. These pulleys allow your tendons to glide freely. If these pulleys become thickened or the tendon develops a swelling, these pulleys constrict around the tendon and stop the tendon from moving freely causing pain or irritation to the affected area. When making a fist the tendon can get stuck which causes your finger or thumb to click or lock in a bent position.
This condition can occur if you have gout, rheumatoid arthritis or diabetes. However this may not be the case as trauma to the base of the finger can cause trigger finger/thumb. In many cases the cause of this condition is unknown.
Symptoms
- Pain or tenderness in your finger/thumb, more so when a fist is made or when trying to grip.
- Pain the palm of your hand.
- Stiffness or swelling in the affected finger.
- Clicking sensation during movement of your finger.
- The affected finger can become stuck and you may need to pull this straight using your other hand.
Treatment
Non-Surgical Treatment
In some cases trigger finger can get better without any treatment, however if not treated the affected finger may become permanently bent which can make everyday tasks difficult.
Rest and medication - avoid any activity that increases the pain. Non-steroidal anti-inflammatory medication can be given to help to ease the pain.
A plastic splint can be applied to the affected area to help ease your symptoms.
Steroid injection may be given to reduce swelling. In many cases one or two steroid injections can be curative for this condition. If two injections do not cure the condition, surgical treatment is the next step.
Surgical Treatment
Surgery is a minor procedure and is used when other treatments are unsuccessful. The surgery is usually performed under local anaesthetic. This involves releasing the affected pulley to allow the tendon to move freely and thus stopping the locking or sticking of the finger/thumb.
A soft bandage is applied for 5 days following the operation. After that the wound is kept covered with a light dressing until the stitches are removed usually in 12 to 14 days after operation. Light use of the hand is permitted immediately after the operation.
Once the stitches are removed progressive return to all usual activities may commence. Mr Miranda and/or the Hand Therapists will advise you about return to activities for your own unique circumstances.
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