What does it feel like?
Most patients describe pain in the affected finger or thumb, particularly with a bit of pressure at the base of the digit. Typically, the symptoms are worse in the morning, with a sensation of fullness in the finger, and a clicking or catching with flexion and extension of the finger (making a fist and opening the hand). Occasionally, these can ‘lock’ in a flexed position, requiring assistance from the other hand to open up again.
What is it?
It is a thickening of the lining of the tendon as it passes through a pulley in the hand. Pulleys in the hand are termed by a series of numbers, and in the case of trigger fingers, it is the A1 pulley (the first annular pulley for the flexor tendon in the hand). Because the tendon has increased in diameter, and also because the pulley may have thickened with time, the normal gliding action of the tendon becomes interrupted and ‘sticks’ while the tendon slides back and forth with flexion and extension.
What causes it?
A nodular thickening in the tendon or its lining as well as thickening of the A1 pulley can arise spontaneously. It can also be caused by conditions that affect the linings of tendons, like rheumatoid arthritis. Swelling in the hand from trauma, or pregnancy, or even recent hand surgery, can also cause triggering of the digit.
What are my treatment options?
Hand therapy can help with splints, exercises and gentle massage. In early trigger digits, this can be quite effective. A corticosteroid injection can also be administered, which aims to reduce the inflammation and swelling in the affected region. In many patients, there is often a short period where the symptoms may worsen while the corticosteroid begins to take effect, followed by improvement.
Surgery is an option for consideration if non-operative measures either do not completely resolve the problem or if your finger becomes locked, and cannot be corrected. Speak to your doctor about a referral to a hand surgeon who can discuss all your options with you in greater detail.