“Trigger finger”, a common threat that gets worse from malpractice

Trigger finger or stenosing tenosynovitis is a symptom of a finger feeling stuck when bending, causing uncomfortable and unnatural movements to the finger
Trigger finger results from long-term repetitive hand usage of the same actions such as clenching a fist or pushing an object
Trigger finger is commonly found in women, patients with diabetes or rheumatoid arthritis, officer workers, and athletes who hold a racquet or a club
To prevent trigger finger, avoid using hands and fingers too heavily as well as holding an object tightly for a long time
Trigger finger treatments include finger exercises, reduction of excessive finger usage, anti-inflammatory drug intake, or surgery
A surgical treatment for trigger finger starts with making a 1-centimeter-long opening at the stuck tendon sheath followed by cutting it to relieve the cause of movement interruption
Chances of recurrence after natural trigger finger treatments are higher compared to the surgical solution, which is as low as 2%
Trigger finger is not a symptom which goes away on its own. At kdms Hospital, we have a wide ranges of non-surgical treatments for trigger finger, from laser therapy, shockwave therapy to ultrasound-guided trigger finger release

In the current time, trigger finger or stenosing tenosynovitis is found more commonly as people tend to use their hands in activities that bend, contract, or stretch the fingers repetitively and violently. Those activities cause friction between the tendon surface and its sheath and lead to inflammation or swelling which obstructs the movement of the finger. In most cases, the inflamed tendon causes uneven movement or pain in the finger when bending. More severe symptoms include snapping sensation when bending or extending the finger and finger locking. Leaving trigger finger untreated might cause chronic symptoms and eventually affect the quality of life.

Table of Contents

What is trigger finger?

Trigger finger is a symptom which causes an uneven movement at the finger tendon. When clenching or stretching the finger, the patient might feel snapping sensation or locking at the finger which hinder its natural movements. Trigger finger is able to occur at the joints or at the base of all fingers.

What causes trigger finger?

Trigger finger results from long-term repetitive hand usage of the same actions such as clenching a fist or pushing an object. These activities induce inflammation and swelling in the tendon, leading to an obstruction when the tendon moves through the tendon sheath. Over a period of time, this condition will eventually turn into trigger finger.

What are the symptoms and stages of trigger finger?

Trigger finger results from long-term repetitive hand usage of the same actions such as clenching a fist or pushing an object. These activities induce inflammation and swelling in the tendon, leading to an obstruction when the tendon moves through the tendon sheath. Over a period of time, this condition will eventually turn into trigger finger.

Trigger finger symptoms are sorted into 3 stages regarding their severity as follows:

Stage 1: Pain at the base of the finger on the fore hand (palm) side

Stage 2: Pain and snapping sensation at the base of the finger

Stage 3: Finger locking, meaning the finger is unable to stretch after bending. There are 3 levels of finger locking conditions as shown below:

Finger locking, with the ability to stretch or bend after using the force of that finger
Finger locking, which needs help from the other hand to stretch or bend that finger
Finger locking, which is unable to move even by the force of the other hand

Risk factors of trigger finger

Trigger finger is commonly found in women, patients with diabetes or rheumatoid arthritis, and athletes who use a racquet or a club as an equipment such as golfers, tennis players, badminton players, and more. Officer workers also have potentials to develop trigger finger as well from the excessive use of a computer keyboard.

How to prevent trigger finger and its risks

To stay away from trigger finger, avoid using your hands and fingers too heavily as well as holding an object tightly for a long time. These behaviors may lead to muscle spasm and increase the risks of developing trigger finger.

What are the treatments for trigger finger?

In order to treat trigger finger, there are 2 types of treatment methods which are our principles to combat these abnormalities.

Non-surgical trigger finger treatments

1. Finger exercises

Steps of finger exercises for treating or alleviating trigger finger in a natural way are as follows:

Dip the hand in lukewarm water for 5 minutes to relax the tendon and tissues
Stretch the fingers to the opposite direction of the stiffness
Hold the posture for 10 seconds and clench the hand
Repeat the exercises until the trigger finger pain is alleviated or the stiffness is relieved

2. Reduction of excessive finger usage

It is important to avoid doing some activities in order to recover from trigger finger. Such activities are the actions that require hands and fingers to bend, contract, or stretch repetitively and violently, for example, using a mobile phone non-stop for a long run or holding heavy items. If this behavioral change is not applied to the patient’s routine, it might take longer time or more intensive approach to cure this symptom. Moreover, the chances of recurrence after recovery is also higher.

3. Anti-inflammatory drug intake

If finger exercises and reduction of excessive finger usage do not help relieve the trigger finger symptoms, the doctor might prescribe anti-inflammatory drugs to reduce the pain. If the pain still remains, a local injection of steroid will be performed at the base of the inflamed finger.

4. Surgical trigger finger treatments

For severe cases, a local steroid injection and other treatments might not work to relieve trigger finger. Therefore, the doctor will consider surgery to solve the problem at the root cause. To perform a surgical treatment, a surgeon will make an opening at the stuck tendon sheath followed by cutting it to enhance the tube so that the tendon moves smoothly without interruption. To return normality to hand functions, the patient will receive medication and physiotherapy before and after the surgery.

Preoperative trigger finger self-care

Trigger finger surgery is a minimally invasive surgery which takes 5-10 minutes for the operation, so normal patients do not require special preparation beforehand. There are requirements for patients of some chronic diseases to consult their physicians and pause some medications before surgery such as antiplatelet drugs, anticoagulants, or immunity-related drugs.

Postoperative trigger finger self-care

After trigger finger surgery, the patient is able to use the finger as normal. The only condition is to avoid getting the wound wet for 10-14 days before stitch removal.

The perks of trigger finger surgery at kdms Hospital

At kdms Hospital in Bangkok, Thailand, we are a one-stop service for trigger finger treatments and therapies, providing both surgical and non-surgical methods. For non-surgical treatments, we have a wide range of cutting-edge technologies which offer alternative ways to cure trigger finger that suit each patient the most. These include:

Laser therapy
Shockwave therapy
Ultrasound-guided trigger finger release

For surgical treatment, you can rest assured as kdms Hospital selects experienced surgeons specializing in bones and joints to take care all of our patients. We ensure that your trigger finger surgery will be performed with minimized risks and high efficiency.

In summary

Lifestyles of people in today’s world pose higher risks to developing trigger finger, from addiction to mobile phone and tablet usage to excessive heavy activities of fingers and hands all day long. Therefore, if you realize that your fingers do not work properly as they used to do such as pain at the base of the finger, snapping sensation or difficulty when extending or bending the finger, do not hesitate to consult a doctor. Early trigger finger diagnosis means early treatment and recovery from the symptoms, probably without surgery.

An article by Supakorn Buranawongtrakoon, M.D., Experienced Hand, Wrist and Arm Surgeon

Q&A

Physiotherapy is not required after trigger finger surgery. However, if the finger joints are stiff due to lack of post-operative movements, the patient is recommended dipping the fingers in lukewarm water and bending them to relieve stiffness.

Surgical trigger finger treatment is not as frightening as you think. Standard surgery for trigger finger is to make a 1-centimeter-long opening at the stuck tendon sheath followed by cutting it to relieve the cause of movement interruption.

This open surgery allows surgeons to target the operative position clearly, reducing risks of surgical errors that damage surrounding nerves. This trigger finger treatment is safe, causes less pain, and spends only 5-10 minutes for the operation.

After trigger finger surgery, the patient is able to use the finger as normal. Except for chronic trigger finger patients, they might have suffered from joint stiffness for a long time and need physiotherapy for a short period after surgery to alleviate the moving difficulty.

Chances of recurrence after natural trigger finger treatments are higher compared to the surgical solution. The recurrence rate after surgical trigger finger treatments is as low as 2%.

Typically, patients do not recover from trigger finger by themselves unless there is a treatment. Patients who suffer from mild symptoms are able to choose the method of behavioral changes and finger exercises as remedies. However, patients with chronic finger conditions will be prescribed a surgical solution as a must.

Consult symptoms before scheduling an appointment.