Trigger finger is one of the most common problems of the hand. Patients experience a painful clicking and catching of the fingers and thumb. The so called “triggering” can be quite painful and debilitating. The pain may even radiate into the hand and forearm. The problem occurs with attempted flexion and extension of the involved digit. For some patients, trigger finger surgery is the best option to resolve the condition. It can be worse in the mornings when patients are first getting up or aggravated by activities later in the day that call for forceful gripping.
Scar tissue in the palm at the base of the finger causes the problem. This scar tissue, though quite benign, prevents the tendon from moving back and forth across the finger. It literally catches beneath the pulley that the tendon glides through. The nerves are close by and the scar tissue irritates them resulting in pain.
Treatment is straightforward and is twofold. The first is corticosteroid injection directly into the palm. The idea is to soften and decrease the scar tissue around the pulley to prevent the catching and clicking. This also treats the associated pain. The steroid acts only locally and does not affect other areas. Sometimes injections can definitively cure the problem, but usually patients require repeat injections. In some cases, the scar tissue becomes too extensive for the shot to be effective and the patient requires direct trigger finger surgery excision. This results in a definitive cure in almost all cases.
Because of the proximity of the critical structures of the hand and fingers, we recommended that board certified hand surgeons treat this problem.
Dr. Lakshman completed an orthopedic fellowship in Surgery of the Hand and is board certified. He takes the time to thoroughly explain the condition and ease your fears. Whether you decide on the injection or surgery, he will go out of his way to make you comfortable and lessen pain. If you have trigger finger, go to the experts for your care.