by Ryan Klinefelter, MD
Trigger finger (also known as stenosing tenosynovitis) is the second most common condition seen by hand surgeons. It is caused by the tendon that flexes the finger getting caught as it moves through a tunnel into the finger. This tunnel starts in the palm just before the web spaces. Over time, the entrance to this tunnel can thicken, narrowing the tunnel. The tendon can then get caught as the finger moves from a position of finger flexion into extension. This causes a catching, popping, or “triggering” of the finger. Additional symptoms include pain, swelling, and stiffness.
The condition is considered idiopathic (i.e. the cause is unknown). Medical conditions such as diabetes and thyroid disease are risk factors. It is not caused by osteoarthritis (typical “wear and tear” arthritis) but is more common in patients with inflammatory arthritis such as gout or rheumatoid arthritis.
Trigger finger is a very treatable condition. The most common first line treatment is a corticosteroid injection into the finger. Injections can actually cure this condition in over half of patients. Splinting is also an option. Surgery is considered for patients with painful trigger fingers after failure of conservative treatment. The results of surgery are generally excellent. It is done on an outpatient basis and patients can use the hand for light activity immediately.