Non-surgical methods of treating trigger finger are usually tried first. These include: 

Hand therapy

• Wearing a splint
  
• Anti-inflammatory medications 
• Steroid injection to the finger
  

If symptoms persist, surgery is recommended. Trigger finger surgery is usually a minor procedure performed under local anesthesia, which involves the release of the tendon tunnel to create more space.

With surgical intervention, there is a less than 5% chance of trigger finger recurring.

Trigger finger occurs when the tendons in your finger or thumb become inflamed, leading to irritation as they pass through the sheath that surrounds them. This inflammation causes the tendon to thicken, making it difficult to move smoothly.

Over time, this results in the characteristic locking or catching sensation. The underlying cause is the repeated friction or stress on the tendons, often due to frequent gripping motions or hand use.

While anyone can develop trigger finger, those engaged in activities that strain the hand muscles are more likely to experience this condition.

Who is at risk of developing trigger finger?

Factors that increase a person's risk developing trigger finger include:

• Being 40 years old and over: Individuals over the age of 40 are more likely to develop trigger finger due to tendon wear.
• Females: Women have a higher risk, possibly due to hormonal factors affecting tendon flexibility.
• Engaged in repetitive hand use: Activities like gripping tools or playing instruments increase tendon strain.
• Certain medical conditions: Diabetes (Type 2 Diabetes Mellitus) and rheumatoid arthritis (RA) raise the likelihood of tendon inflammation.
• Having a previous hand injury: A history of hand trauma can increase susceptibility to trigger finger.

Trigger finger typically develops gradually, with symptoms that can range from mild to severe. The condition primarily affects the tendons in your fingers or thumb, causing discomfort and restricted movement. Below are the key symptoms to watch out for:

1. Stiffness in the finger
   One of the earliest symptoms is stiffness, particularly in the morning. The affected finger may feel tight or difficult to move, especially when attempting to bend or straighten it.
2. Clicking or popping sensations when moving the affected finger
   As the condition progresses, you might notice a clicking or popping sensation when moving your finger. This is caused by the tendon catching as it moves through the sheath, leading to a feeling of resistance.
3. Pain or tenderness in the finger
   Pain is a common symptom and can occur at the base of the affected finger or thumb. The area may also become tender to the touch, making gripping objects or using the hand uncomfortable.
4. Swelling or a lump on the finger
   A small bump or nodule may develop at the base of the affected finger. Swelling may also occur, making it harder for the tendon to move smoothly within the sheath.
5. Finger has limited range of motion
   Over time, the range of motion in the affected finger may become limited. Everyday activities such as gripping, writing or typing may become more difficult and painful.
6. Finger locked in a bent position (advanced cases)
   In more advanced cases, the finger may lock in a bent position and be difficult to straighten. In some instances, the finger can only be moved with assistance or considerable effort, causing significant discomfort.

If you experience any of these symptoms, it is important to seek medical advice early, especially if the condition begins to interfere with daily activities. Early treatment can help prevent further complications.

Trigger finger is typically diagnosed through a physical examination. In most cases, no additional tests like X-rays or scans are required, as the condition can be diagnosed based on symptoms and hand movement alone. 

However, if there is concern about underlying conditions, your doctor may order further tests.Based on the examination, a grade will be assigned to your trigger finger or thumb based on the severity of your condition:

Grade 1: Mild discomfort and occasional locking.

Grade 2: Locking occurs during physical examination, but you can still straighten your finger or thumb.

Grade 3: Difficulty bending or straightening your finger or thumb, interfering with daily activities.

Grade 4: Finger or thumb is stuck in a bent position, causing significant pain.Ref:

G25 (ed)

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