Trigger finger is known to be common in people with diabetes and rheumatoid arthritis. Dr Darryl Chew from the Department of Hang Surgery at Singapore General Hospital provides an overview.
"Triggering" describes the distinct catching or locking that occurs when the finger is bent or straightened. This condition involves the pulleys and tendons which bend the fingers. The tendons usually glide through the pulleys in the finger. When the pulley at the base of the finger becomes too thick, it constricts the tendon and a tendon nodule forms. This size mismatch prevents smooth gliding of the tendon. The pulley "catches" the tendon and results in triggering.
What causes trigger finger?
The causes for trigger finger are not always clear. Some are associated with diabetes, gout and rheumatoid arthritis. Occasionally, trauma to the palm or base of the finger may be a factor, but in most cases the cause is not clear.
How do I recognise if I have trigger finger?
Trigger finger or thumb may start with an ache or tightness felt at the base of the finger or thumb. A nodule may be felt in this area. Triggering or locking occurs on opening or closing of the fingers. When this catching sensation occurs, this may sometimes be mistaken as a problem of the middle knuckle of the finger.
How is trigger finger treated?
- The treatment goal is to eliminate the catching or locking, and to allow full movement of the finger or thumb without discomfort.
- Wearing a splint or taking oral anti-inflammatory medication may sometimes help.
- Changing activities, such as reducing the amount of gripping, is also useful.
- An injection of steroids into the area around the pulley is often effective.
- If these forms of treatment do not provide relief, your doctor may recommend surgery. This is a minor surgical procedure which can be performed as a day surgery under local anaesthesia. The pulley at the base of the finger is opened, allowing free gliding of the tendon. Surgery is almost always successful and you will regain normal use of your hand upon recovery. In certain cases, hand therapy is required after surgery to regain normal function of the hand.