Trigger Finger / Thumb

Why does it occur?

Triggering of the thumb or a finger can occur spontaneously or as a result of an injury. The sheath (tunnel) around the tendon becomes swollen and inflamed at the base of the thumb or finger which affects how it moves.

What are the symptoms?

The thumb or finger can become 'locked' after it has been bent. Straightening it may only be possible with assistance from the other hand. More than one finger may be affected. Sometimes there is a painful swelling at the base of the affected thumb or finger.

Investigations

A thorough history should be sufficient. There may be exacerbating factors which need to be investigated including control of diabetes (if relevant), or rheumatoid arthritis.

Treatment options

  • Non-operative treatment

Rest the hand - this may allow the problem to resolve without the need for treatment.

Steroid injection - this targets the exact location of the problem and acts to reduce inflammation. This procedure combined with rest may allow the problem to resolve.

  • Operative treatment

Trigger Thumb / Finger Release - this is a short day-case procedure which is performed after a local anaesthetic injection (you are awake and talking to the surgeon and theatre staff).

The area will become numb although you will be aware of pressure. A small incision is made at the base of the affected digit and the sheath is released. The tendons are checked to ensure that movement is occurring freely and that the triggering action has been resolved.

Stitches are  placed in the skin will and dressings will be applied.

Complications

Stiffness - this may be due to an underlying condition. Rarely the triggering recurs.

Nerve/blood vessel injury- avoided by careful surgery, the nerves to the thumb are particularly at risk.

Chronic regional pain syndrome- more pain and stiffness occurring after operations or injuries, 1%

Rehabilitation after surgery

Once the dressings have been removed there are no restrictions to movement. Stitches will be removed after 7 days.

Frequently asked questions