Understanding Your Trigger Finger

A trigger finger or thumb is a common painful condition which causes the fingers or thumb to lock in a bent position.

Tendons that help bend the fingers slide through a protective covering known as the tendon sheath. The main problem in a trigger finger, stems from either the opening of the sheath becoming smaller, or the tendon itself becoming thickened, so that it can no longer slip smoothly through the tendon sheath.

When trying to straighten the affected finger, the inflammed portion of the tendon momentarily gets stuck at the mouth of the tendon sheath, then pops as the tendon eventually makes its way through this tight area. This is what causes the "triggering".

In severe cases, the "stuck" finger can only be straightened with the help from the other hand.

Who Gets Trigger Finger?

Trigger fingers tend to be more common in women than men, typically affecting those between 40 to 60 years of age. They are also more commonly associated with certain medical conditions:

Rheumatoid arthritis

Diabetes mellitus

Gout

How is it Treated?

Mild cases may improve with just rest and anti-inflammatory medication. Sometimes, splints may be used to enforce rest of the affected finger.

Hydrocortisone and lignocaine (H&L) injections are frequently given to treat trigger fingers, however, they tend not to be very useful if the trigger finger has been present for a long time, or when it is associated with other medical conditions, such as diabetes. H&L injections should also not be given more than 3 times a year, as too frequent repeated injections in the same area, would increase the risk of tendon rupture.

For intractable cases, which do not improve with medical treatment or H&L injections, surgery may have to be considered. Basically, surgical treatment of trigger fingers, involves widening the opening of the tendon sheath, so that the tendon can once again slide through more easily. This is done via a small incision in the palm of the hand. Post-surgical physiotherapy may be required to help reduce joint stiffness.

Dr Ang C.D. has been in medical practice for over 12 years. He graduated with an M.B.B.S. degree from the National University of Singapore in 1997 and subsequently completed his post-graduate diploma in Family Medicine. He has had training in Emergency Medicine, Internal Medicine, Geriatric Medicine, Orthopaedic Surgery, Obstetrics & Gynaecology, Neurosurgery, General Surgery, Colorectal Surgery and Urology.

Dr Ang currently practices in a family clinic in Singapore, seeing a good mix of paediatric, adult and geriatric patients. With the goal of providing local and international patients with a resource for specialist care in Singapore, Dr Ang has founded SingaporeDoc.com, a Web Directory of Specialists in Private Practice in Singapore.

Understanding Your Trigger Finger

By: Christine

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