Trigger Finger / Trigger Thumb

Trigger finger and trigger thumb are extremely common. The problem is very similar to carpal tunnel syndrome except that, instead of the median nerve getting pinched, it’s the tendon that moves your finger or thumb that gets compressed. People usually wake up in the morning with one or more of their fingers stuck down against the palm of their hand. Pulling it straight causes a significant amount of pain. Once it warms up the finger may move, but there is a painful locking/clicking. Forceful gripping may also be painful. Splinting may prevent the finger from bending and catching, but usually doesn’t provide any long-term cure.

If you catch it early, trigger finger may be cured by a steroid injection. After 4-6 months the chance of an injection permanently curing the condition is lower, but still worth a try. If the trigger finger returns following an injection, subsequent injections often have “diminishing returns”, meaning they won’t work as well or last as long. If an injection fails, consideration should usually be given to having a surgical trigger finger release.

The trigger digit release is an outpatient surgery performed under local anesthesia. There’s a nurse anesthetist present to provide sedation for those who don’t want to feel or remember anything. A small incision is made, the tight area of the tunnel that the tendon is stuck in is cut open and the wound closed. It only takes 6-7 minutes, and it’s almost always a permanent cure. There are no stitches to remove. Just keep the hand clean and dry for 4 days and avoid submerging it under water for 10 days. I’d also recommend avoiding heavy activities like lifting and gripping for a couple of weeks, in order to minimize post-operative pain.

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