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What is Trigger Finger?
Trigger finger is a condition that can occur in any finger or the thumb. The finger clicks or locks when the fingers roll up into a fist, and use is often painful.
What causes Trigger Finger ?
The flexor tendon (which rolls up the finger into a fist) fits perfectly in a smooth tunnel. This tunnel can thicken at various points, usually in the palm. The tendon develops a lump or thickening which snags at the tunnel narrow point and can block. This constant impact as the tendon slides back and forth, sets up inflammation, which is painful and tender. This may follow a period of heavy use, such as gardening or DIY activities, but in many cases there is no identifiable cause.
What are the symptomns?
- In the initial stages, the finger is painful to use, and the tendon is tender when pressed or when something is held in the hand.
- As it develops, the finger clicks, sometimes painfully, with use
- In more advanced stages, the finger locks so that it is possible to straighten it only by using the other hand.
- It is quite common for the clicking to be felt in the end joint, when the tendon problem is at the base of the finger.
How is Trigger Finger treated?
- Mild trigger finger will sometimes resolve spontaneously, especially if the hand is rested from heavy activity.
- In cases which click painfully but do not lock, steroid injection into the tendon tunnel will often resolve the problem. This does not work instantly but causes the thickening to resolve over a period of some 3 weeks, during which the hand can be used normally.
- In cases which lock, or if there is recurrence after injection, the blockage can be relieved by surgery. This is done under local anaesthesia (if multiple trigger fingers are released at the same time, this may require regional block – the arm is numbed from the wrist, or the neck) or general anaesthesia, as a day case, and will require you to elevate your hand above the level of your heart, for a variable period, advised by your surgery. It is important to keep the finger moving through its full range, after surgery, but to limit any use. This sort of surgery is generally permanent and recurrence is uncommon.
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