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What is trigger finger?

A trigger finger/thumb is caused by a nodule in the tendon catching it as it passes through a tunnel at the base of the finger /thumb.

What are the usual symptoms?

The commonest symptom is clicking or locking of the finger / thumb when it bends associated with pain. It may be difficult or impossible to fully straighten the finger/thumb and require forcefully pulling straight. It may feel like the joint is dislocating. There is commonly a painful area at the base of the finger /thumb and you may notice a nodule and clicking sensation if you feel the tender area.

What causes it?

The cause of the nodule is usually unknown although it occurs more frequently in diabetics and patients with rheumatoid arthritis.

In the vast majority of cases there is no arthritis and the joints are not affected or damaged by this condition.

What are the treatment options?

•Some trigger fingers/ thumbs do not require treatment, but persistent symptoms and pain may require treatment.

•The most simple treatment is to inject a small amount of cortisone (steroid) around the nodule. This can be done in the out-patients and although slightly uncomfortable at the time, can get rid of the problem in about 70-80% of cases. You can use the hand normally after the injection but it can take a few weeks to respond to the injection.

•Surgery may be required if the injection(s) are not successful.

What does the operation involve?

The operation usually uses local anaesthetic to ‘freeze” the skin at the bottom of the finger/thumb. During the operation the area where the nodule is catching is released. You should only feel a small amount of pushing and touching but no pain. The skin takes 10-14 days to heal.

Will I be able to use my hand after surgery?

You will have a bandage on your hand, which will be reduced in size in 3-7 days, but you should not wet your bandage. You will be encouraged to use your hand gently within the limits of your bandage avoiding pressure over the front of the wrist.

The scar is over a sensitive area at the front of the hand and you should try to avoid pressure over this area as well as strenuous manual activities, such as gardening and DIY for about 2 weeks.

You will be able to drive after 3 to 5 days.

Can the operation do me any harm?

The risk from cortisone injection is extremely small.

In those cases requiring surgery, there is also some risk of damage to other tissues around the operation site, particularly the nerves to the finger although this is also very rare. There will be a scar, which may be sore for a few weeks. Infection in the wound can occur but is usually simple to treat with antibiotics. Recurrence of symptoms after surgery is very rare.