Trigger finger may sound like it’s something that happens to cowboys or police officers, but it’s actually pretty common. Trigger finger, or stenosing tenosynovitis in medical terms, is a condition that causes one or more of your fingers to get stuck in a bent position (as if you are squeezing a “trigger”).
Typically affecting the ring finger and thumb, trigger finger causes stiffness, pain, and the sensation of popping or snapping when you straighten or bend your finger. When the thumb is affected, the condition is sometimes called “trigger thumb.” Depending on its severity, treatment options for trigger finger can range from rest and anti-inflammatory medications to surgery.
As a renowned hand surgeon and a leader in minimally invasive hand surgery, Dr. Fitzmaurice is uniquely qualified to help patients identify whether they may have a trigger finger and what options they have to get relief. Read below for more information on trigger finger and possible treatments.
Finger motion is guided by tendons, which consist of flexible cords of tissue that connect bones to muscles. These tendons pass through tunnels (tendon sheaths) in the palm and fingers, allowing the bones to glide smoothly back and forth. When there is a tendon that cannot glide freely, or when a tendon sheath becomes inflamed or irritated, the finger’s movement is compromised. While its exact causes are unknown, trigger finger is more common with certain medical conditions such as diabetes, gout, and rheumatoid arthritis. Forceful and repetitive hand activities may also increase the risk of developing the condition. Trigger finger, therefore, frequently affects farmers, musicians, hobbyists, industrial workers, and others who perform strenuous repetitive motions, as well as strong gripping or grasping. It is also common among women and in individuals 40-60 years of age.
An early sign of trigger finger is discomfort at the base of the finger or thumb and sensitivity to pressure. Other symptoms include:
Symptoms often start out mild and gradually become more severe over time. They are also usually worse in the morning (or after periods of inactivity), while firmly grasping or gripping something or first attempting to straighten your finger.
Your doctor will be able to diagnose trigger finger through a physical examination, as well as a discussion of your symptoms, medical history, and prior injuries. An ultrasound is often used to confirm the diagnosis and evaluate for treatment options. There are no lab tests or X-rays required to diagnose this condition. During an examination, your doctor will check for any swelling or thickening of the tendon sheath, triggers when you bend or straighten your finger, and tenderness over the flexor tendon sheath in your palm.
The goal of a trigger finger treatment plan is to eliminate swelling and uncomfortable sensations, such as catching and locking, in order to allow for the restoration of motion. The initial treatment for the condition is typically non-surgical. Depending on the severity and duration of the problem, doctors will prescribe a range of conservative treatment options such as:
Steroid injections are typically the most effective conservative treatment. We use an ultrasound along with the patient’s treatment history to estimate the effectiveness of conserative techniques. For severe cases, these conservative treatments are less effective and patients are better off proceeding with surgery compared to less severe cases which have a better result with conservative treatment. If the condition does not respond to the available non-surgical treatments and the symptoms continue to recur, surgery may be recommended.
Surgery for trigger finger is performed to increase space in your finger so that your flexor tendon is able to move. Michael Fitzmaurice M.D. of the Fitzmaurice Institute has developed a patent-pending system specifically designed for the treatment of trigger finger or trigger thumb. The EndoTech® Endoscopic Trigger Finger Release is performed with only a minimal incision done under a local anesthetic. This cutting-edge, minimally invasive instrumentation system allows for complete visualization of the tendon and digital nerve. The thickened tissue over the tendon is safely divided, resulting in the restoration of movement to the tendon. This eliminates pain while also protecting the nerve from injury.
Traditional open procedures involve large incisions, sutures that need removal after 10-14 days, and 6 weeks of recovery time. EndoTech®, on the other hand, requires only a single small incision (less than 1 cm) that allows for much less pain and faster healing with minimal scar tissue. The incision is simply covered with a Band-Aid and patients can notice significantly less pain by the first follow-up visit within two weeks. Patients can also immediately begin using their affected fingers for light activity and return to their normal activities in just one week. Recovery time will also depend on the patient’s age, general health, and the longevity of symptoms.
The EndoTech® Endoscopic Trigger Finger Release procedure provides the safest, most effective, and minimally invasive treatment option for trigger finger, resulting in a much higher success rate and a greater overall patient outcome.
Our team of hand specialists at the Fitzmaurice Institute is dedicated to providing comprehensive care for your hand problems. Our surgeons will help determine the best procedures and therapies to restore form and maximize hand function. We’ve also combined everything you will need into one location. Our exam rooms, operating rooms, and urgent care center are designed to make treatment as convenient as possible. If you’d like to learn more about trigger finger or if you are considering getting treatment for it, contact us to schedule a consultation.