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Trigger Thumb

 

What is Trigger Thumb?

Trigger finger, also known as stenosing tenosynovitis or flexor tendonitis, is a condition where one of the fingers or thumb of the hand is caught in a bent position. The affected digit may straighten with a quick snap, similar to pulling and releasing the trigger on a gun, hence the name trigger finger.

Symptoms of Trigger Thumb

Commonly reported symptoms associated with trigger finger include the following:

  • Bent finger suddenly pops out and straightens
  • Finger movement creates a "popping" or "clicking" sound or sensation
  • Finger feels stiff and sore
  • Finger becomes bent with inability to straighten

Symptoms are worse in the morning.

Causes of Trigger Thumb

Trigger thumb is caused by inflammation of the tenosynovium. The tenosynovium is the substance that lines the protective sheath around the tendon in the finger. This substance enables the tendon to glide smoothly within the sheath when the finger is bent or straightened. When inflammation is present, the tendon is unable to glide smoothly within its sheath causing "catching" of the thumb in a bent position and then suddenly releasing the finger straight. Causes of trigger thumb can include the following:

  • Repetitive motion: Individuals who perform heavy, repetitive hand and wrist movements with prolonged gripping at work or play are believed to be at high risk for developing trigger thumb.
  • Medical conditions: Conditions associated with developing trigger thumb include hypothyroidism, rheumatoid arthritis, diabetes, and certain infections such as TB.
  • Gender: It is more common in females than males.

Diagnosis of Trigger Thumb

Hand and wrist conditions should be evaluated by an orthopedic hand surgeon for proper diagnosis and treatment. Trigger thumb is diagnosed based on the medical history and physical examination and without any special testing required.

Conservative Treatment Options for Trigger Thumb

Your surgeon will recommend conservative treatment options to treat the trigger thumb symptoms. Treatment options will vary depending on the severity of the condition and may include the following:

  • Rest the hand for 2-4 weeks or more by avoiding repetitive gripping actions. Avoid activities that tend to bring on the symptoms.
  • Ice over the affected finger may help symptoms. Apply ice over a towel for 5-15 min, 3-4 times daily.
  • Non-steroidal anti-inflammatory drugs (NSAIDs) may help to relieve pain and inflammation.
  • The finger is immobilized in an extended position with a splint[Please link to Casting and Splinting] for 4-6 weeks. This places the finger in a neutral position enabling the joint to rest.
  • Strengthening and stretching exercises with the affected finger may be suggested.
  • Occupational therapy may be recommended for massage, heat, ice and exercises to improve the finger.
  • Steroid injections into the affected finger may help reduce the inflammation in the finger.
  • Treating any underlying medical conditions that may be causing the problem, such as diabetes or arthritis.

Indications for Trigger Release Surgery

Your surgeon may recommend percutaneous trigger release surgical procedure to release the tendon in the following cases:

  • Conservative treatment options fail to resolve the condition
  • Symptoms persist for 6 months or more
  • Your quality of life is adversely affected