Trigger Finger

Trigger finger can be described based on how long the condition has been present and the pattern of symptoms:

• Acute trigger finger is a condition where symptoms appear suddenly, often after overuse or injury.
• Chronic trigger finger is a condition where symptoms persist over time due to repeated strain and thickening of the pulley.

Trigger finger presents with a range of symptoms that can vary from mild discomfort in the early stages to significant functional limitation in advanced stages.

• Clicking or stiffness at the base of the affected finger or thumb, especially in the morning or after rest.
• Pain at the base of the finger (A1 pulley) in the early stages.
• Fixed locking or weakness of the affected finger or thumb in advanced stages.
• Clicking or stiffness at the base of the affected finger or thumb, especially in the morning or after rest.
• Pain at the base of the finger (A1 Pulley) during the early stages.
• Fixed locking or weakness of the affected finger or thumb in advanced stage of the disease.

Most of the patients are healthy adults with no underlying cause. However, some risk factors include:

• Female sex.
• Diabetes and rheumatoid arthritis.
• Gripping activities.

Trigger finger is diagnosed primarily through clinical evaluation, supported by imaging studies to rule out other conditions and assess tendon involvement. 

• Physical examination.
• X-rays to rule out arthritis. 
• Ultrasonography to see the condition of the affected tendon pulley.
• Magnetic resonance imaging (MRI) to assess any causes for the swelling/compression.
   

Based on the intensity of the symptoms and the patient’s response to initial therapies, one or more of the following approaches may be recommended by doctors:

• Non-surgical treatment:
  • Splinting the finger/thumb in a straight position, especially during the nighttime can be tried in initial cases with some response.
  • Activities like gripping should be avoided in some cases.
  • Physiotherapy may be beneficial in relieving the pressure around the pulley. Additionally, anti-inflammatory medications may provide temporary relief in the initial stages.
  • Around 50%–60% of the patients respond well to local steroid injections around the A1 pulley to reduce the inflammatory process. A maximum of 2 such injections can be tried.
• Surgical treatment:
  • Local or regional anaesthesia may be used for the surgery depending on the medical condition, pain threshold, and disease stage.
  • Open surgery involves an incision of around 2 cm at the base of the finger/thumb and releasing the A1 pulley completely, which is usually seen as a tight constricting band.
• After surgery:
  • A sterile dressing is applied after the surgery; the patient is asked to perform the finger movements as early as possible.
  • Complete recovery can take up to 2–3 weeks.

Patients are advised to consult with their doctor if they experience persistent pain, stiffness, or locking of the finger or thumb that interferes with daily activities or if their symptoms do not improve with rest and simple measures.

Certain lifestyle practices can help reduce the risk of developing trigger finger or prevent symptom progression.

• Avoid repetitive gripping or forceful hand activities when possible.
• Use ergonomic tools to reduce strain on the hand.
• Take breaks during tasks that require prolonged hand use.
• Perform hand and finger stretching exercises to maintain flexibility.

Patients with trigger finger should consult an orthopaedic surgeon or a hand specialist for diagnosis and management.