Pain in the hand, along with difficulty opening or closing fingers could be the sign of “trigger finger.” While it can be alarming for someone who has never had issues with their hands before, it has a relatively simple solution.
“Trigger finger is the most common hand problem I encounter in my clinic,” said Ariel Williams, MD, an orthopedic surgeon at Yale New Haven Health and assistant professor of Orthopaedics & Rehabilitation at Yale School of Medicine.
What causes trigger finger?
The tendons that flex the fingers run through tunnels. Each tunnel is made up of a series of pulleys, which act like belt loops around the tendons to prevent bowstringing. The first pulley, called the A1 pulley, is where ‘triggering’ happens. When there’s a mismatch between the flexor tendons and the size of the A1 pulley, the flexor tendons can no longer glide smoothly through the pulley, which causes catching and locking or “trigger finger.”
It typically starts to happen as people age, but it can occur in younger patients as well. Other risk factors can include diabetes and obesity, but Dr. Williams says it can happen to anyone.
Symptoms can include pain, as well as catching or “clicking” of the finger. That happens when someone opens their finger from a bent position and they feel a catch, sometimes along with an audible click.
“Sometimes the problem goes away on its own but it can also get worse over time,” said Dr. Williams. “Sometimes a severe trigger finger will get so bad that the finger will lock in a bent position.”
Treatment for trigger finger
Trigger finger treatment may include a steroid injection or surgery to cut the A1 pulley, so the tendon no longer catches. This procedure can be done in an operating room or procedure room and is most often done under local anesthesia. It takes about five minutes and patients can return home the same day. Patients can even have surgery on multiple trigger fingers if they are impacted.
Dr. Williams says after surgery, patients can use their hands right away for light day-to-day activities like eating and brushing their teeth. It takes around three weeks for the skin to heal and usually during this time patients will experience some swelling and soreness. Most patients are fully back to their normal activities in about four weeks.
“People are often surprised to hear the problem can be solved with a quick procedure under local anesthesia,” Dr. Williams said. “Sometimes people feel silly coming to me with a problem like this because they feel like it shouldn’t be a big deal, but this is something I see all the time. We use our hands so much that even mild triggering can cause noticeable discomfort and impairment. If people do have this problem and are bothered by it, they should go and see a hand specialist without any hesitation.”
