Ask the Experts
Trigger Finger Surgery
Trigger finger/ Trigger thumb
Trigger finger also known as Stenosing Tensynovitis, is a common hand condition, that occurs when the tendons in the fingers do not glide smoothly. Tendons are tissues that connect our muscles to our bones, and these can get stuck when the fingers bend. This makes it hard to straighten the fingers and the thumb back out, causing pain, discomfort and swelling. This can happen on any of the fingers including the thumb.
Tendons pass through a tunnel called the tendon sheath and they allow fingers to straighten or extend. Normally tendons glide smoothly over the tendon sheath however if the tendons are swollen or develop a nodule (small round mass) this can make it difficult for the tendons to pass through the sheath. The tendons then get stuck causing the ‘popping’ or ‘catching’ feeling, as well as causing pain and more swelling. Your fingers then become stuck in one position, making it hard to bend or straighten.
It’s not always clear what causes trigger finger, and it is a lot more common in women than men. It mostly occurs in people in their 40s to 60s who may also have certain medical conditions, such as diabetes, rheumatoid arthiritis, autoimmune disease, and gout. You can also be born with a nodule on the tendon. Repetitive hand movements such as holding tools can also cause tendon irritation.
Usually you will develop pain and discomfort at the base of the finger/ thumb, and this pain can extend to the palm as well. The area may be swollen and you might feel a small lump. It will be difficult to bend and straighten your fingers and it can feel like they are getting stuck when you move them. This may feel worse in the morning. In the most severe cases, the fingers can become stuck and don’t move.
Our specialist orthopaedic hand surgeon Mr. Richard Diaz can diagnose Trigger Finger by examining your hand and ask you about your symptoms and level of pain, and feel for any clicking or popping during movement.
Once the diagnosis is confirmed, Mr. Dias will explain the treatment options. Treatment will depend on the duration and severity of symptoms and may include:
- Rest: If a repetitive movement is contributing to your trigger finger, avoiding that activity for a time can ease the condition.
- Oral anti-inflammatory medication: Over-the-counter medicines, such as ibuprofen or naproxen, can decrease the inflammation causing trigger finger and alleviate pain.
- Cold packs: Icing the affected area can help with swelling and pain. Be sure to follow instructions on proper ice treatment methods.
- Splinting: Wearing a splint at night that keeps the finger extended can help rest the tendon.
- Stretching exercises: Physiotherapists can create customized home exercise programs for all manners of hand and wrist injuries and disorders.
- Steroid injections: A local steriod injection can be a fast and effective treatment to reduce inflammation from trigger finger and maintain mobility. Steriod injections are one of the most common treatments for trigger finger and typically offer relief for at least a year. Some patients require more than one injection to see results.
- Percutaneous release: This in-office surgical procedure involves inserting a needle into the surrounding tissue of the tendon to break up the constriction and open the sheath.
- Surgery: Trigger finger surgery is typically performed on an outpatient basis in an operating room and is only recommended if more conservative treatments are unsuccessful in relieving pain and reducing symptoms. A small incision is made at the base of the affected finger and the tendon sheath is opened to allow the tendon to glide freely.
More about the surgeon, Mr. Richard Dias
|Degrees||MBBS, FRCS Glasg (Tr & Orth)|
|Areas of Expertise||
Mr. Richard G. Dias
Consultant Orthopaedic Hand & Upper Limb Surgeon
Richard Dias developed an interest in Hand and Upper Limb Surgery very early in his career while doing Plastic Surgery as an Intern in 1990. After his basic surgical training he completed his Specialist Training on the Birmingham Orthopaedic Training Programme.
He went on to do a Hand Fellowship at the Pulvertaft Hand Centre under the mentorship of Professor Frank Burke, followed by an Upper Limb Fellowship and finally took up post as a Consultant Orthopaedic Hand and Upper Limb Surgeon in Wolverhampton.
During his hand fellowship he had the opportunity to work with Professor F Burke and Dr M. Garcia-Elias, both of whom are internationally renowned for their contributions to the development of hand and wrist surgery.
He is a perfectionist by nature and tailor-makes his treatment and rehabilitation to his patients needs so as to give them the best possible outcome.
This becomes increasingly important in the treatment and rehabilitation of elite athletes where their sporting requirements and training schedules demand an accelerated phase of rehabilitation following surgery.
- Specialist Training on the Birmingham Orthopaedic Training Programme.
- He has travelled around Europe to learn and evaluate new techniques in hand and upper limb surgery.
- He is an Honorary Senior Lecturer, University of Birmingham and the Clinical Lead for orthopaedic undergraduate education at his institution.
- He also mentors physiotherapists for their MSc degree.