What is Trigger Finger and how do you treat the affected finger or thumb? Mr Sam Molyneux, Orthopaedic Consultant at The Edinburgh Clinic explains.

• What is trigger finger (or thumb)?

• How does Trigger Finger happen?

• What are the symptoms?

• What is the treatment?

• What is the outcome?

What is trigger finger?

Trigger finger is a condition which causes pain and catching of a finger or thumb as it is bent towards the palm.

Why does it happen?

The finger flexors are the muscles that pull the fingers inwards to make a fist. They are held in place by a series of tight tunnels over the front of the finger. Occasionally a small area of one of the flexor tendons can swell to form a nodule. This nodule rubs in the tunnel holding the tendon in place and causes pain.

Occasionally the nodule gets big enough that it gets stuck as it tries to get into one of the tunnels, stopping the tendon and the finger from moving. This can cause a click and difficulty straightening the finger. Occasionally it can get so stuck that it is impossible to straighten the finger at all.

We don’t really know why the nodule forms. It is more common in people with diabetes but can happen in anyone. Occasionally people describe injuring their hand but in most people the condition simply develops without any reason.

What are the symptoms?

The chief symptoms are pain and sometimes difficulty moving the finger from a bent to a straight position. The pain is usually at the palmar surface of base of the finger or thumb but it can spread along the palmar surface of the whole finger. Some people can feel a lump in this area. Some people struggle to move their finger from a bent to a straight position. When they do this they feel a resistance and pain before the finger goes suddenly straight with a click. Occasionally people are unable to straighten their finger at all.

What is the treatment?

The aim of treatment is to let the nodule move within the tunnel more easily.

Splinting the finger straight at night can help and these splints can usually be supplied by a physiotherapist.

An injection of local anaesthetic and steroid into the painful area can also be very effective, although sometimes the problem does come back. Sometimes more than one injection is needed.

Where surgery is required, a simple operation, usually done under local anaesthetic, releasees the tunnel around the nodule so that it doesn’t rub. This procedure is extremely effective and very safe and, after surgery, patients are encouraged to get back to their usual activities very rapidly. The surgery involves a small cut about 1cm long in the palm just near the base of the finger. The tunnel over the nodule is then cut and the skin sutured back together. Immediate finger movement is encouraged.

Most patients should try working their way up the treatment options, only requiring surgery when other options have failed. An exception is patients who are completely unable to straighten their finger from a bent position – these cases should be seen by a surgeon rapidly to allow consideration of operative release.

What is the outcome?

Trigger finger is a nuisance, but with adequate treatment the problem can usually be overcome and most patients will get back to their normal function with minimal long term pain or difficulty.

The Edinburgh Clinic’s specialist Orthopaedics and Sports Injuries facility is expert in treating Trigger Finger and welcomes self-pay and insured patients from Edinburgh, the Lothians and across Scotland.

To learn more about our treatment click here or call 0131 447 2340 to make an appointment