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Trigger finger

Treatments for trigger finger

Trigger finger may improve without treatment in some people. Pain relievers such as ibuprofen, a splint on your hand, steroid injections to reduce swelling, and surgery are all options for treating trigger finger.

The most common non-surgical treatment for trigger finger is steroid injections. They have up to a 90% success rate for people who are not diabetic.

Between 20 – 30 % of people with trigger finger or trigger thumb may require surgery to correct the condition.

Conservative treatment methods

For those with less severe conditions, resting the finger or thumb and limiting or avoiding activities that exacerbate the condition until symptoms improve are the first steps. This usually takes 3 to 4 weeks.

To stop the finger or thumb from moving, a splint may be put on the afflicted finger or thumb in an extended position at night for up to 6 weeks. While wearing a splint can be beneficial for some people, it is often less successful than other therapies, especially over time. Some of the stiffness associated with trigger finger may be relieved by gentle stretching and strengthening activities. They can also help with thumb and finger range of motion.

If abstaining from related activities, splinting or stretching exercises have no effect and symptoms continue, anti-inflammatory medicines such as ibuprofen (also a painkiller) or steroid injections may be prescribed.

To decrease tendon swelling and allow the tendon to move more freely, steroids like corticosteroids are injected into the base of the affected finger. It usually takes a few weeks for the corticosteroids to take effect but can take only a few days in some cases.

Injections of corticosteroids are estimated to permanently improve the condition in 50 to 70% of cases. However, the condition can reappear after a corticosteroid injection and people with certain underlying health conditions, such as diabetes and arthritis, may find them less effective. A second injection can be administered but it is generally less effective than the first.

Corticosteroid injections for trigger finger carry few risks. On rare occasions can cause minor thinning or colour change in the skin at the injection site. There's also a slight chance of the injection site becoming infected.

 

Surgical treatment methods

Surgery for trigger finger or thumb is a safe procedure and complications are rare. Your Consultant will discuss the procedure in more detail with you prior to treatment.

The amount of pain you're in, whether it's linked to other medical issues like rheumatoid arthritis, and how much it's affecting your life will all play a role in whether surgery is required.

If conservative treatment methods do not work or are ineffective, surgery may be advised. Your tendon will be able to move freely again once the surgeon corrects the problematic area of the tendon sheath through careful incision. Trigger finger surgery is effective, and the condition in the treated finger or thumb rarely returns.

If you have diabetes or are experiencing severe symptoms, it is often suggested you have surgery sooner rather than later.

The space around the tendons of the afflicted finger or thumb is increased by cutting the tendon sheath, making it easier for the tendon to pass through.

 

Surgical options

Open trigger finger release surgery
Medical practitioners have typically chosen open surgery because it has a minimal risk of complications.

Open trigger finger release surgery is done under local anaesthetic, so you will be awake during the procedure but will feel no discomfort. The surgeon makes a small incision in your hand, about half an inch, along the natural creases. This makes the tiny scar less visible once fully healed. The tendon sheath is made wider during the procedure enabling the tendon inside to move unhindered. After that, the wound will be closed with stitches and covered with a light bandage.

Percutaneous trigger finger release surgery
This is a type of keyhole surgery so there’s no cutting or incision and therefore, no scar. A needle is inserted into the skin at the bottom of your affected tendon and used to unblock the affected area. Ultrasound is used to ensure the tendon sheath is opened.
The middle and ring fingers are the most popular targets for this surgery.

Percutaneous release surgery has a minor risk of damaging blood vessels or nerves near the tendon sheath, however this is outweighed by the lack of scarring and faster recovery time.

Tenosynovectomy
This is usually recommend if the symptoms are severe, the first two options have not been successful or are unsuitable, such as in those suffering from rheumatoid arthritis.

A tenosynovectomy involves removing part of the tendon sheath, allowing the finger to move freely again. It is carried out under local anaesthetic and takes about 30 minutes.

 

Types of surgery for trigger finger

Open trigger finger release surgery and percutaneous trigger finger release surgery are normally performed. A tenosynovectomy, or tendon removal, may be required instead if you are unable to have open or percutaneous surgery or have rheumatoid arthritis as open and percutaneous procedures might cause your finger to drift sideways.

  • Open trigger finger release surgery
  • Percutaneous trigger finger release surgery
  • Tenosynovectomy