Stenosing tenosynovitis is commonly known as “trigger finger” or “trigger thumb.” The tendons that bend the fingers glide easily with the help of pulleys. These pulleys hold the tendons close to the bone. This is similar to how a line is held on a fishing rod (Figure 1). Trigger finger occurs when the pulley becomes too thick, so the tendon cannot glide easily through it (Figure 2).
What Causes Trigger Finger?
Trigger fingers are more common with certain medical conditions such as rheumatoid arthritis, gout and diabetes. Repeated and strong gripping may lead to the condition. In most cases, the cause of the trigger finger is not known.
Signs and Symptoms?
Trigger finger may start with discomfort felt at the base of the finger or thumb, where the finger joins the palm. This area is often sensitive to pressure. You might feel a lump there. Other symptoms may include:
- Catching feeling
- Limited finger movement
What are the Treatments?
The goal of treatment in trigger finger is to eliminate the swelling and catching/locking, allowing full, painless movement of the finger or thumb. Common treatments include, but are not limited to:
- Night splints
- Anti-inflammatory medication
- Changing your activity
- Steroid injection
If non-surgical treatments do not relieve the symptoms, surgery may be recommended. The goal of surgery is to open the pulley at the base of the finger so that the tendon can glide more freely. The clicking or popping goes away first. Finger motion can return quickly, or there can be some stiffness after surgery. Occasionally, hand therapy is required after surgery to regain better use.
Why have Dr. Brown Treat my Trigger finger?
Dr. Brown will try all conservative methods prior to surgery, But in some cases surgery is necessary. Dr. Brown is the only surgeon in the Permian basin WALANT procedures (wide awake local only no tourniquet). This technique allows the surgery to be done without general or sedation anesthesia. It eliminates the risks of anesthesia and makes the recovery from surgery on the day of the procedure very simple. In many cases these surgeries can be performed in the office setting, which saves you both time and money! Most patients report this as a painless procedure. The surgery typically takes around 15 minutes and you are in the office a total of around 45 minutes. There are 2-3 small sutures in the palm that are removed at 10 to days post-operatively.