Trigger Finger & Trigger Tumb (Stenosing Tenosynovitis)
My finger clicks and gets stuck
If you have noticed a painful lump at the base of your finger or thumb and/or occasionally the finger/thumb clicks or even gets stuck, you probably are suffering from trigger finger or trigger thumb.
What is a trigger finger/thumb?
Every finger has two flexor tendons and the thumb has one flexor tendon. These tendons run in a tunnel (fibro-osseous sheath) which has reinforcements (pulley). Fingers have five pulleys and the thumb has three. When the tendon sheath thickened, it can get stuck underneath the pulley and cause pain and triggering.
Who gets trigger finger/thumb?
Often the condition is short lived after heavy labour or strenuous exercise which required repetitive finger motion. However it is not uncommon that the tendon sheath thickens over time and the condition becomes a chronic inflammation (stenosing tenosynovitis). It can also occur as part of a ‘systemic inflammatory arthropathy’ such as rheumatoid arthritis.
Symptoms of trigger finger and trigger thumb
The condition mostly starts with pain and swelling in the palm at the base of your finger or thumb. Fingers might feel swollen. As the condition progresses and the tendon sheath becomes thicker, flexion of fingers causes pain and a click and eventually the finger or thumb might get stuck in flexion or is unable to flex because the tendon is stuck at the pulley.
How is trigger finger/thumb diagnosed?
History and clinical appearance are typical for trigger finger and trigger thumb and often triggering can be demonstrated. Ultrasound can image the thickened and bulging tendon tissue.
Treatment for trigger finger/thumb
In an acute situation rest and anti-inflammatory medication can resolve symptoms quickly. If pain persists, ultrasound guided cortisone injection can help manage the local tendon sheath inflammation. In chronic cases where theses measures have failed to succeed or the finger is stuck, surgery is an option.
Surgery for trigger finger/thumb
This surgery can be carried out as day surgery, often under local anaesthetic. Sedation is at the patients choice. A small incision is required at the first pulley mostly. The pulley is split and the tendon cleared of inflamed tissue.
Preparing for surgery for trigger finger and trigger thumb
If required we will arrange for a bulk billed pre-admission clinic at the hospital. This is run by a specialist anaesthetist who will gather information and request investigations that are required for safe anaesthesia. Our reception staff will advise of costs, hospital and admission details.
Recovery from surgery for trigger finger/thumb
Recovery after surgery for trigger finger and trigger thumb is quick. The mechanical irritation is removed once the pulley is split and triggering and locking of finger will not happen anymore. The wound heals with in ten days and a hand therapist will care for dressings changes, removal of sutures and exercises. Full recovery should have occurred by the time of the two week post operative review appointment.