These days, you’re having trouble buttoning your blouse and even playing your favorite song on the guitar. And it’s all because of your trigger finger.
Trigger finger is a condition where your thumb or finger remains stuck in a flexed or bent position. This condition impacts 2-3% of people in the United States.
The question is, if you’ve been diagnosed with trigger finger, when is it time to consider trigger finger surgery?
Here’s a rundown on the top four signs you might need trigger finger surgery and how surgery may help.
Let’s dig in!
What Is Trigger Finger?
This hand condition is formally called “stenosing tenosynovitis.”
This medical condition occurs when something causes a tissue band in your hand called the “pulley” to become inflamed. The pulley is responsible for holding your tendon against your finger bone, mostly in your thumb or ring finger.
The pulley’s inflammation makes the space around your tendon, called the “sheath,” narrower. This causes the stiffness and discomfort associated with trigger finger.
When you suffer from trigger finger, your hand might hurt even if you’re not using it. In addition, you may not be able to perform the activities you desire to do. This may even include playing video games with your children, for example.
Trigger Finger Causes
It is not fully clear what leads to trigger finger. However, strenuous or repeated hand movements appear to play an immense role in this medical condition.
That’s because activities that require you to repeatedly flex, or bend, your finger can stress or irritate the flexor tendons in your finger. These tendons make bending your fingers possible.
Repetitive tasks can also inflame your tendon sheath.
Examples of activities that require repetitive or excess grasping or gripping include pulling a firearm trigger, for example.
Specific factors also increase your chances of experiencing trigger finger. For instance, you have a greater chance of developing this condition if you suffer from gout, rheumatoid arthritis, or diabetes. The condition affects 10% of diabetics.
You’re more apt to experience trigger finger if you are 40 to 60 years of age. In addition, women are more likely to suffer from this condition than men.
Also, let’s say you suffer a hand injury that impacts the base of a thumb or finger or your palm. This can also increase your chances of experiencing trigger finger.
Symptoms of Trigger Finger
The symptoms of trigger can start out mild and then become severe over time. Let’s take a look at the four core symptoms of trigger finger.
1. Hand Pain
Perhaps you’re feeling pain in the area of your hand where the palm meets your fingers — the fingers’ base area. This is a major sign you may need trigger finger treatment, like surgery.
In addition to feeling pain in this area, you might feel tenderness. This tenderness and pain will likely flare up if you overuse your fingers.
2. A Small Lump
You might also notice a bump at your finger’s base area if you are suffering from trigger finger. This is another indicator that you have trigger finger.
The lump in this area might be painful when you touch it or apply pressure to it. You may especially notice the bump when you attempt to use the affected finger.
3. Popping Sound
This is yet another sign that you have trigger finger. You may especially hear a clicking/popping sound when you extend or move your finger.
The popping occurs in the area where your sheath has become inflamed. That’s because your tendon is forced to begin squeezing through the area to aid in extending your finger.
The popping sound associated with trigger finger is similar to the sound your knuckles or fingers make when you crack them.
4. Locking Up
Finally, if you’re struggling with limited finger movement, this is an indicator you need trigger finger treatment.
The pain you feel may cause you to keep your thumb or finger in one position. Unfortunately, this may cause your finger to become locked in a bent, or curled, position.
In addition, your sheath might become inflamed to the point where your tendon becomes stuck in a single position. You might experience this when making a fist. When you release your fist, your impacted finger will stay stuck in a certain position.
In this situation, your finger may look like it would if you were trying to pull a gun trigger. And when you try to extend your finger, it seems to catch or lock up during this process.
To resolve this problem, you might try to manually extend your bent finger with the other hand. This is a sign that your trigger finger case is severe, in which case you need medical attention.
Trigger Finger Treatment Options
If your doctor diagnoses you with trigger finger, they may recommend non-surgical treatment options first.
Let’s look at a few conservative treatment options that may fix your issue, in which case you can avoid the risks associated with surgery.
Resting Your Hand
Your doctor may ask you to rest your hand for 3-4 weeks. This means you can’t do any activities requiring repetitive motion during this period.
If you can’t avoid activities requiring excessive or forceful hand use altogether, you should at least try to limit these activities. In addition, if you have to do them, take frequent breaks during them.
Splinting
A doctor might furthermore ask you to put on a splint every night for as many as six weeks. This will help you to keep your impacted finger straight as you sleep. It will also help you to rest your affected tendon.
Medications
You might also be asked to take anti-inflammatory medications that don’t contain steroids.
These medicines include ibuprofen, such as Motrin IB and Advil. They may also include naproxen, like Aleve. Note that these medications, which are readily available in the store, may ease your pain but likely won’t decrease swelling in your hand.
Hand Exercises
Hand exercises may also help you to address your trigger finger problem. These gentle exercises are designed to help you to maintain mobility in the problematic finger.
You might also be asked to complete exercises that involve helping your tendon to glide. However, you’ll likely have to perform these exercises under a therapist’s guidance.
Steroid Treatment
Another treatment option your doctor may suggest is a steroid injection, also known as a cortisone shot.
The injection would go into or near your tendon sheath to decrease inflammation. This would promote the free gliding of your tendon again.
Note that this treatment might take one day or even several weeks to fully take effect. Then, when you feel its effects, you can expect this relief to last for one year or more. The shot may even cure your problem.
If one shot doesn’t work, then your doctor may suggest that you receive a second cortisone shot.
Steroid injections are frequently recommended for treating pain because they are effective for many patients. Still, they might not be as effective for people with trigger finger. The same is true for people with diabetes.
Trigger Finger Surgery
If the above-listed methods do not work for you, your doctor may propose surgery. Hand surgery may especially be warranted if your trigger finger is preventing you from engaging in activities you would normally do.
Through surgery, your doctor can give the flexor tendon more room to move. As a result, you’ll be able to finally flex and bend your finger again without pain.
Best Candidates for Surgery
Surgery may be the best option for you if your hand issues are severe. For instance, your restricted hand or finger movement may be especially bothersome. In addition, if your forearms, hands, thumbs, or fingers are suffering from disabling pain, surgery might be in order.
You should also go with surgery if doing daily tasks is painful or awkward. These tasks may range from activities you like, such as hobbies, to work.
Perhaps you feel nervous or embarrassed about suffering from trigger finger. Surgery may be a wise choice for you as well.
Trigger finger may additionally be a smart move if your trigger finger has worsened over time. As a result, you might be constantly dropping items. Likewise, you may struggle to pick items up, or you may have a hard time grasping objects.
Finally, if you have diabetes, your doctor may recommend that you undergo surgery because steroid shots may not help you much.
Before the Surgery
On the day after your surgery, you will not be allowed to eat. In addition, on the night before your surgery, you may have to eat dinner a bit earlier than normal if your surgery is early the next morning.
During your fasting period, you should refrain from drinking beverages like milk, juice, soda, and especially alcohol. Drinking water is okay.
During the Surgery
Your doctor may perform open surgery or a percutaneous release surgery.
Open surgery can be done in the outpatient setting. This means you won’t have to stay in the hospital overnight. This surgery might take several minutes to 30 minutes.
During this procedure, you will receive a sedative via an intravenous line, which will make it easier for you to relax. Your doctor will then numb your hand and cut a small incision in the palm.
Next, your doctor will cut your tendon sheath. Afterward, they’ll move the finger around to ensure a smooth motion. Your doctor will then close your cut with switches.
A percutaneous release surgery is most frequently done for ring or middle fingers. A doctor can perform this procedure in their office.
To perform this procedure, your doctor will numb your palm and insert a needle into your skin near your impacted tendon. Then, they’ll move your finger and the needle to try to remove the area that is blocked. No incisions or cutting is necessary.
After the Surgery
You should have no problem moving your impacted finger after your surgery once the numbness has worn off.
However, depending on the nature of your job, you might have to take some time off following your procedure. Although you can use a computer keyboard immediately after your surgery, you may have to wait a couple of weeks to perform jobs involving strenuous labor.
In addition, you should keep a bandage on your finger for 4-5 days. The wound needs to stay dry during this period.
Keep in mind that your palm and finger will feel sore for several days after the surgery. However, ice packs may help with easing the pain.
Also, to minimize swelling, you should regularly keep the hand that was operated on propped up above the heart. You might also need to consult a therapist to learn how to do specific hand exercises in your free time.
Driving shouldn’t be a problem within five days of your surgery. However, you should avoid playing recreational sports for 2-3 weeks. Only then will your wound be healed, at which point you’ll have the grip strength you need to perform at your optimum level.
Finally, don’t be alarmed if it takes between three months and six months for your stiffness and swelling to disappear. Your recovery time might be briefer if you underwent percutaneous release surgery. Meanwhile, it might be lengthier if your surgery involved multiple fingers.
In some situations, one surgery isn’t enough. Fortunately, it is not common for trigger finger to recur in a patient.
How We Can Help With Trigger Finger Surgery
If you are experiencing hand pain or popping, you may need to undergo trigger finger surgery. The same is true if your symptoms include limited movement in your finger.
Fortunately, at the Hand Surgery Specialists of Texas, we have treated many patients suffering from trigger finger. We can evaluate your hand and provide you with the most appropriate treatment for your situation, such as trigger finger surgery.
Get in touch with us to learn more about your trigger finger treatment options, and schedule an appointment today!
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