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Trigger Finger & Trigger Thumb

Trigger finger and trigger thumb arise when the flexor tendons enlarge, making it difficult for them to move smoothly through the tunnel they go through. As a result, a finger or thumb may click or pop when attempting to straighten it. While painless, the condition can sometimes cause discomfort, and the affected digit may become stuck in a bent position.

In severe cases, the finger or thumb may be unable to straighten on its own and may require surgical correction.

Symptoms

  • Pain at the triggering area, typically in the palm (for fingers) or on the palm side of the thumb near the mid joint. This is most common in individuals over 40.
  • Tenderness when pressing on the affected area.
  • Clicking or locking of the finger or thumb during movement that tends to worsen in the morning. The digit may become stuck in a bent position and may require assistance from the other hand to straighten.
  • Stiffness, particularly in the trigger thumb, where motion at the tip of the thumb may be limited.

Causes

When the opening of a tendon tunnel thickens, it creates friction against the tendon, causing it to catch at the tunnel’s entrance. While individuals with insulin-dependent diabetes are more susceptible to trigger finger and trigger thumb, the condition most commonly occurs in those without diabetes. In some cases, triggering may develop following an injury, like a direct impact on the hand.

There is little proof to suggest that work-related activities cause the condition, but pain can be worsened by tasks performed at home, work, in the garden, or during sports. In people with rheumatoid arthritis, triggering may result from tendon nodules, but it is not linked to osteoarthritis.

Diagnosis

A healthcare provider can diagnose the trigger finger and trigger thumb through a physical examination. They will assess your hand and fingers, ask about your symptoms, and inquire when you first experienced pain or stiffness. Be sure to mention if any specific activities worsen your symptoms.

During the exam, your provider may attempt to straighten your fingers or thumb to check for clicking and assess tendon stiffness. Let them know if any movement causes discomfort.

Diagnostic tests:

In most cases, special tests aren’t necessary to diagnose trigger finger and thumb. However, imaging tests such as ultrasound or X-rays may be used to examine the tissues and bones in the hand if needed.

Treatment Options

While considered harmless, trigger finger and trigger thumb can be a painful inconvenience. Some mild cases improve on their own within a few weeks and without any treatment. Available treatment options include:

Activity modification

If possible, refrain from activities that contribute to pain.

Splinting

Wear a small splint at night to keep the finger or thumb straight. A hand therapist can fit a splint, but a temporary alternative, like a lollipop stick secured with tape, can also be used. Keeping the finger straight when sleeping helps smooth the roughened tendon.

Steroid injections

Steroid injections help ease the pain as well as triggering in almost 70 percent of cases, though success rates are minimal for individuals with diabetes. Improvement can be noticed within days following the shot administration, but it might take a few weeks. A second injection may be beneficial, but persistent cases may require surgery.

Percutaneous trigger finger release

Some surgeons prefer using a needle to release the tight tunnel, performed under local anaesthesia. While less invasive, this method isn’t ideal for all cases or digits.

Surgical decompression of the tendon tunnel

This is performed under local, regional, or general anaesthesia. A small cut is made to widen the tendon tunnel by cutting its roof while carefully avoiding nearby nerves. Afterward, the wound will need a small dressing for 10 to 14 days; however, light hand use is possible immediately, and movement aids recovery.

Pain relief is normally quick, though the scar may remain tender and red for a few weeks. Return of triggering following surgery is rare.

Conclusion

Trigger finger and trigger thumb can be frustrating and painful, but effective treatments are available. Whether your symptoms are mild or persistent, early intervention can help restore comfort and mobility. If you’re experiencing pain, stiffness, or difficulty moving your digits, don’t wait for the condition to worsen.

Book an appointment today to discuss your symptoms and explore the best treatment options for you.