Trigger Finger Release
The ability to bend the fingers is governed by supportive tendons that connect muscles to the bones of the fingers. The tendons run along the length of the bone and are kept in place at intervals by tunnels of ligaments called pulleys. When the fingers bend, or are straightened, a slippery coating called tenosynovium helps the tendons smoothly glide through the ligaments with reduced friction.
Inflammation in the tenosynovium leads to a condition called trigger finger, also known as stenosing tenosynovitis or flexor tendonitis, where one of the fingers or thumb of the hand is caught in a bent position. The affected digit may straighten with a quick snap, like pulling and releasing the trigger on a gun, hence the name trigger finger.
Signs and Symptoms
Commonly reported symptoms associated with trigger finger include the following: -
- Pain and tenderness over the inflamed tendon nodule
- Bent finger suddenly pops out and straightens
- “Popping” or “clicking” sound or sensation when the nodule moves through the pulley
- Finger feels stiff and sore
- Finger gets locked, with inability to straighten when the nodule grows large and gets stuck in the pulley
- Symptoms are worse in the morning
Long-term complications of untreated trigger finger can include permanent digit swelling and contracture, as well as tearing of the tendon or rupture.
Your surgeon will recommend conservative treatment options to treat trigger finger symptoms. Treatment options will vary depending on the severity of the condition.
Conservative treatment options may include the following:
- Treating any underlying medical conditions that may be causing the problem, such as diabetes or arthritis
- Rest the hand for 2-4 weeks or more by avoiding repetitive gripping actions. Avoid activities that tend to bring on the symptoms.
- Strengthening and stretching exercises with the affected finger may be suggested.
- Occupational therapy may be recommended for massage, heat, ice and exercises to improve the finger.
- Ice over the affected finger may help the symptoms. Apply ice over a towel for 5-15 min, 3-4 times daily.
- Non-steroidal anti-inflammatory drugs (NSAIDs) may help to relieve pain and inflammation.
- Steroid injections into the affected finger may help reduce the inflammation.
If conservative treatment options fail to resolve the condition and symptoms persist for 6 months or more and your quality of life is adversely affected, your surgeon may recommend a surgical procedure to release the tendon.
Percutaneous trigger finger release surgery is a minimally invasive procedure performed under local anesthesia. Your surgeon makes one small incision to the affected finger area, about an inch long, and releases the tight portion of the flexor tendon sheath.