Trigger Finger and Trigger Thumb (Tenosynovitis)

Hand Surgeon Mark E. Pruzansky, MD and Jason S. Pruzansky, MD can help you experience less pain and recover quicker from hand, wrist and elbow surgery through minimally invasive surgery techniques. Call our Concierge Services at 212-249-8700 to schedule your appointment.

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What are Trigger Finger and Trigger Thumb?

Trigger Finger and Trigger Thumb are common examples of tenosynovitis, inflammation of tendons of the hand and wrist.

Tendons and pulleys help your fingers and thumbs bend. Normally, the flexor tendons easily fit through the sheath in each finger and pass back and forth without difficulty as the finger bends and straightens.

When the flexor tendons of a finger or thumb become swollen (tenosynovitis) they get stuck in the tube-like sheath around them. If the tendons become swollen, the sheath cannot accommodate them.

Consequently, as the tendons try to move in and out of the sheath they become stuck and then pop through, leading to triggering.

Symptoms of Trigger Finger and Thumb

Mild discomfort at the base of your finger or thumb, where the joints meet your palm, may be the start of trigger finger. You may also notice increased sensitivity in this in area along with a small lump which is the inflamed tenosynovium.

Classic Symptoms

  • Pain with moving the finger.
  • Tenderness in the palm.
  • Triggering or clicking.

Sometimes there may be triggering, but with minimal pain.

Severe Cases

  • Tendons have become so swollen and the sheath so tight that the tendons cannot even pass all the way through.
  • Limited range of motion of the finger without actually triggering.

Common Causes of Trigger Finger and Thumb

Trigger Finger most commonly occurs due to a genetic predisposition. Other causes may include injury as well as diseases like Diabetes, Hypothyroidism, Gout, and Rheumatoid Arthritis.

Diagnosing Trigger Finger and Thumb

The examination is as simple as speaking with you to understand your symptoms, your daily activities, and carefully examining your hand.

If an x-ray of the hand is performed, it is used to evaluate or eliminate other reasons that may be causing you to experience pain and stiffness.

Treatment Options for Trigger Finger and Thumb

The most common, initial treatments involve:

  • Less forceful use
  • Anti-inflammatory medication
  • Ergonomic training
  • Cortisone injections xylocaine

Persistent cases that do not respond to steroid injections may benefit from surgery. The procedure is minimally invasive and involves opening part of the sheath, so that the flexor tendons have more room to move.

What to expect after trigger finger surgery

  • First, the clicking or popping goes away.
  • Increased finger motion generally returns quickly.
  • Some stiffness can occur.
  • Physical therapy for the hand may be needed to optimize recovery.

Conclusion

Trigger Finger and Thumb are common and can range from being a mild nuisance to causing great difficulty with use of your hand.  Call HandSport Surgery Institute at 212-249-8700 to schedule an appointment and restore your finger’s motion.