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Trigger Finger

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Dr Jacqueline Tan

MBBS (SG) | MRCS (Edin) | MMed (Surgery) | FAMS (Hand Surgery)

Trigger finger, or stenosing tenosynovitis, is a condition where one or more fingers lock in a bent position, causing restricted movement, pain, and tenderness. It occurs when inflammation narrows the protective sheath surrounding the tendons, preventing them from gliding smoothly. Repetitive or forceful movements can lead to swelling, pressure, and nodule formation, further restricting motion.

The condition can cause locking or snapping sensations in the fingers, interfering with daily activities. Prompt diagnosis and treatment are necessary to prevent progression.

Symptoms of Trigger Finger

Symptoms of trigger finger often develop gradually and can vary in severity. Common signs include:

  • Soreness and Pain: Pain and tenderness at the base of the affected finger, particularly near the palm, is a common symptom.
  • Nodule Formation: A small, tender lump may develop near the base of the finger or thumb, corresponding to the inflamed tendon.
  • Snapping or Clicking Sensation: A noticeable snapping or popping sound may occur when bending or straightening the affected finger, often accompanied by pain.
  • Stiffness and Locking: Stiffness, particularly in the morning, may improve slightly with movement but can worsen throughout the day if untreated. Severe cases may result in the finger becoming locked in a bent or straight position, requiring assistance from the other hand to move.

Causes and Risk Factors

Trigger finger develops due to inflammation and narrowing of the tendon sheath. Factors that increase the risk include:

  • Repeated Gripping: Activities or tasks that involve frequent, prolonged gripping, such as using hand tools, texting, or playing musical instruments, increase the likelihood of tendon irritation and inflammation.
  • Medical Conditions: Certain conditions, such as diabetes, rheumatoid arthritis, and hypothyroidism, are linked to an increased risk of trigger finger.
  • Age and Gender: The condition is more common in individuals aged 40 to 60 years and tends to affect women more than men.

Diagnosis of Trigger Finger

Physical Examination

The doctor examines the hand for pain, tenderness, or swelling, particularly near the base of the affected finger. They may check for a palpable nodule and observe finger movement to identify signs of locking, snapping, or restricted motion.

Symptom Review

The patient’s medical history, daily activities, and the progression of symptoms are discussed to determine potential causes and contributing factors.

Imaging Studies (if needed)

While usually unnecessary, imaging tests such as ultrasound or MRI may be used to confirm the diagnosis in unclear cases or to rule out other conditions like arthritis or tendon injuries. These provide a detailed view of the tendons and surrounding structures.

Treatment Options

Treatment for trigger finger aims to relieve symptoms, restore function, and prevent recurrence. Surgery is typically considered when non-surgical methods fail to provide relief or when the condition significantly interferes with daily activities.

Non-Surgical Treatment

Rest and Activity Modification

Reducing repetitive hand movements or gripping activities allows the inflamed tendon to heal naturally, relieving pressure on the tendon sheath. Avoiding aggravating activities is especially necessary during the early stages of the condition.

Splinting

Wearing a splint to keep the affected finger straight, particularly at night, reduces strain on the tendon and encourages healing by limiting movement. Splinting can be used for several weeks to manage symptoms effectively.

Medication

Over-the-counter non-steroidal anti-inflammatory drugs, such as ibuprofen or naproxen, are effective for managing pain and reducing inflammation around the tendon sheath.

Corticosteroid Injections

Injecting a steroid directly into the tendon sheath reduces inflammation, allowing the tendon to glide smoothly again. This treatment is often effective for mild to moderate cases and may provide relief for several months.

Surgical Treatment

Percutaneous Release

This is a minimally invasive procedure where a needle is used to release the constricted sheath, allowing the tendon to move freely. This procedure is typically done under local anaesthesia with a quick recovery time.

Open Surgery

A small incision is made at the base of the finger to release the narrowed sheath, expanding it so the tendon can glide smoothly. This surgery is performed under local anaesthesia, and most patients are discharged on the same day. Post-operative pain is minimal, and patients are encouraged to begin active finger movement shortly after surgery to aid recovery and prevent stiffness.

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Prevention and Management

To prevent trigger finger or manage the condition effectively, focus on minimising strain on the tendons and addressing symptoms early. Take regular breaks from repetitive hand use or gripping tasks, such as typing or texting, to reduce stress on the fingers. Gentle stretching and strengthening exercises can improve tendon flexibility and reduce the risk of inflammation.

If symptoms such as pain, snapping, or locking appear, seek medical attention promptly, as early treatment can prevent the condition from worsening and reduce the likelihood of requiring surgery. Managing underlying conditions like diabetes or rheumatoid arthritis also helps in reducing the risk of trigger finger recurrence.

Frequently Asked Questions

Does trigger finger affect multiple fingers?

Yes, trigger finger can affect multiple fingers, and in some cases, both hands. Individuals with conditions like diabetes or rheumatoid arthritis are at a higher risk of experiencing it in more than one finger.

Is trigger finger a permanent condition?

Trigger finger is not typically permanent. With appropriate treatment, whether non-surgical or surgical, most individuals regain full finger movement and functionality. However, in rare cases, severe or untreated trigger finger may lead to long-term stiffness or reduced mobility.

How long does it take to recover from trigger finger treatment?

Recovery times vary depending on the treatment method. Non-surgical treatments may relieve symptoms within weeks, while surgical recovery typically takes a few weeks to a few months for full functionality.

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Dr Jacqueline Tan

MBBS (SG)

MRCS (Edin)

MMed (Surgery)

FAMS (Hand Surgery)

Dr. Jacqueline Tan is a hand surgeon in Singapore with over 18 years of experience in managing hand, wrist, and nerve conditions. Formerly the Head of Department of Hand and Reconstructive Microsurgery at Singapore General Hospital, she has continued to contribute significantly to her profession.

  • Director of Micro-Reconstruction Service and the Director of Peripheral Nerve and Paralytic Upper Limb Service
  • Upon the completion of her training as a hand surgeon in Singapore, Dr Tan was awarded the prestigious Health Manpower Development Plan scholarship by the Ministry of Health (MOH).
  • Completed a one-year advanced fellowship in Taiwan under the tutelage of internationally-acclaimed Hand and Orthopedic Microsurgeon – Professor Yuan-Kun Tu
  • Dr Tan’s field of expertise is in early and late brachial plexus reconstruction, peripheral nerve disorders, reconstructive microsurgery of the extremities and wrist disorders.

Widely Published
In hand surgery

Active In
Academic Teaching

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    Mt Elizabeth Novena Hospital

    38 Irrawaddy Road #07-42
    Singapore 329563

    Weekdays: 8:30am – 5:30pm
    Saturdays: 8:30am – 12:30pm
    Sundays & Public Holidays: Closed

    +65 9230 9554