Overview

Trigger finger
Trigger finger

Treatment

Treatment

The treatment for trigger finger depends on the severity of your symptoms and how long your have had it.

Sometimes, trigger finger gets better without treatment, so your GP may recommend avoiding activities that cause the pain to see if this helps relieve your symptoms.

Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may also be helpful in relieving pain.

Splinting

Strapping your affected finger or thumb to a plastic splint can ease your symptoms by stopping your fingers moving. If your finger is particularly stiff in the morning, it may help to use a splint overnight. Your GP can advise you about how long you need to wear a splint for.

Corticosteroid injections

Corticosteroids are medicines that can be used to reduce swelling. In cases of trigger finger, liquid corticosteroids are injected into the tendon sheath (the membrane that the tendon slides through), at the base of the affected finger or thumb.

Corticosteroids, are thought to work by reducing swelling of the tendon, allowing the tendon to move freely again. This can sometimes happen within a few days of having the injection but it usually takes a few weeks.

It's estimated that corticosteroid injections are an effective treatment for 50 to 70 % of people with trigger finger. However, they are generally less effective in people with certain underlying health conditions, such as diabetes and rheumatiod arthritis.

A corticosteroid injection can permanently improve trigger finger, but in some cases, the problem can return after treatment. You can have a sewcond injection if the effect wears off, but often less effective than the first injection

the risks of corticosteroid injections for trigger fingers are small. Very occasionally, it causes some thinning or colour change in the skin at the site of injection. There is also a small risk of infection.

Surgery

Surgery may be recommended if the above treatments do not work or are unsuitable. The surgeon will cut through the affected section of the tendon sheath so that your tendon can move freely again.

Whether surgery is recommended will depend on considerations such as the amlount of pain you're in, whether it's associated with other medical problems, such as rheumatoid arthritis, and how much it is affecting your life.

In most cases, trigger finger is a nuisance rather than a serious condition. However, if it is not treated, the affected finger or thumb may become permanently stuck in a bent position or, less commonly, in a straightened postition. This can make carrying out everyday taks difficult.

Surgery for trigger finger is effective and it's rare for the problem to return in the treated finger or thumb. However, you may need to take time off work and there's a risk of complications (see below).

The operation takes around 20 minutes, and you will not need to stay in hospital overnight. the procedure is usually carried out under local anaesthetic, so you will be awake but unable to feel pain in your hand.

The 2 types of surgery for trigger finger are:

  • open trigger finger release surgery
  • percutaneous trigger finger release surgery

If you have rheumatoid arthritis, these types of surgery may not be recommended because they can cause your finger to drift sideways. Instead, a procedure known as a tenosynovectomy may be necessary. This involves removing part of the tendon sheath to allow the tendon to move again.

Open trigger finger release surgery

If you have open trigger finger release surgery, the surgeon will give you an injection of local anaesthetic into the palm of your hand.

A small incision will be made in the palm of your hand along one of the natural creases, which may mean the scar will be less noticable. The surgeon will carefully cut through the tendon sheath to make it wider. the wound will then be closed with stiches and covered with a light bandage.

Percutaneous trigger finger release surgery

Percutaneous means "through the skin". As with open surgery, the surgeon will inject your hand with a local anaesthetic. However, instead of making an incision in your palm, a needle will be inserted into the base of the affected finger and used to slice through the ligament to get to the tendon.

As percutaneious surgery does not involve making an incision, you will not have a wound or scar. However, the procedure is slightly more risky then open surgery and may be less effective at resolving the problem. Important nreves and arteries are very close to the tendon sheath and can easily be damaged. For this reason, open surgery is usually the preferred method

Recovering from surgery

After the procedure, you should be able to move your finger straight away. The dressings can usually be removed after a few days to make movement easier, and full movement should return within 2 weeks.

If you have had open surgery, your palm may feel sore immediately after the procedure, but any discomfort should pass within 2 weeks.

You can start driving again as soon as you feel it's safe for you to drive, which is usually after 3-5 days. You may be able to write and use a computer immediately.

You can play sports after around 2 or 3 weeks, once your wound has healed and you can grip again.

When you can return to work will depend on your job. If you have a desk job or a role that involves light manual duties, you may not need any time off work. If your job involves manual labour, you may need up to 4 weeks off.

If you have had surgery on several fingers, your recovery period may be longer.

If you have had percutaneous surgery rather than open trigger finger release surgery, your recovery period may be shorter because you will not have a wound on your palm.

Caring for your wound

If you have had open surgery, your surgeon should advise you about how to care for the wound in your palm. Washing it with mild soap and warm wateris usually all that's required.

if you have had stitches, you'll be told if you need to return to hospital to have them removed. Some stitches are dissolvable and will disapper on their own in around 3 weeks.

After your wound has healed, you may be left with a small scar running along your palm, where the incision was made.

Hand Therapy

If your finger was quite stiff before surgery, you may need specialised hand therapy after your operation to loosen it. Discuss this with your surgeon before the operation. The types of therapy you may need include:

  • physiotherapy - where manipulation, massage and excercise are used to improve the movement and function of your hand
  • occupational therapy -  if you are struggling with everyday tasks, and activities, either at work or at home, an occupational therapist will be able to give you practical support to make those tasks easier

Complications of surgery

Trigger finger realease surgery is a safe procedure. However, as with any type of surgery, there are some risks.

Complications are rare, but could include:

  • infection
  • stiffness or pain in the finger
  • a trender scar
  • nerve damage (if a nerve is damaged during surgery, you may never recover the full sensation in the affected area)
  • tendon bowstringing, where the tendon is in the wrong position
  • complex regional pain syndrome (CRPS), which causes pain and swelling in your hand after surgery - this usually resolves itself after a few months, but there can be permanent problems.

Before your operation, ask your surgeon to discuss the possible complications and risks with you in more detail.

Treating children with trigger finger

Trigger finger in children will often improve without treatment as the child gets older, although splinting and simpe hand stretches may help.

Steroid injections are not usually used in children, but surgery under general anaesthetic can be carried out if necessary

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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The information on this page has been adapted by NHS Wales from original content supplied by NHS UK NHS website nhs.uk
Last Updated: 05/05/2021 17:37:03