Trigger finger, or stenosing tenosynovitis, is a condition where a finger or thumb becomes stuck in a bent position. This occurs due to inflammation and narrowing of the sheath surrounding the flexor tendon. Symptoms include pain or tenderness at the base of the affected digit, a catching or popping sensation during movement, and stiffness, particularly in the morning. In severe cases, the finger may lock completely, requiring manual assistance to straighten.
Does Trigger Finger Resolve on Its Own?
While some mild cases of trigger finger can resolve spontaneously, this is not a guaranteed outcome. Rest and avoiding repetitive gripping motions can sometimes alleviate symptoms, allowing the inflamed tendon sheath to recover. However, many individuals find their symptoms persist or worsen, especially in more advanced cases.
If symptoms are persistent or interfere with daily activities, seeking medical advice is recommended. Delaying treatment can lead to increased stiffness or a fixed contracture of the finger. Early intervention often leads to better outcomes and can prevent the condition from progressing.
Treatment Approaches for Trigger Finger
Treatment for trigger finger often begins with non-surgical methods to reduce inflammation and restore smooth tendon movement. Rest, along with avoiding aggravating activities, is a primary step. Splinting the affected finger, especially at night, can help keep it straightened, resting the tendon. Over-the-counter anti-inflammatory medications, such as NSAIDs, may also manage pain and swelling.
Corticosteroid injections are an effective non-surgical treatment. An anti-inflammatory medication is injected directly into the tendon sheath at the base of the affected finger, reducing swelling and allowing the tendon to glide freely. Many patients experience relief after one or two injections, though symptoms can return. If non-surgical approaches do not provide lasting relief, surgery may be considered.
Surgical treatment, known as trigger finger release, widens the constricted A1 pulley, the ligament hindering tendon movement. This involves a small incision in the palm to divide the A1 pulley, allowing the flexor tendon to glide without obstruction. The goal of surgery is to alleviate catching and locking, and it is performed under local anesthesia. While the incision heals within weeks, it may take several months for residual swelling or stiffness to resolve.
Prognosis and Recurrence of Trigger Finger
The prognosis for trigger finger is positive, with most individuals experiencing relief from symptoms following treatment. For those who undergo corticosteroid injections, a high success rate is observed. If symptoms return after an injection, a second injection may be administered, but no more than two or three injections are recommended for the same finger to avoid complications.
Surgical release of the A1 pulley offers a high success rate, with most patients reporting significant improvement. Recurrence after surgical treatment is uncommon, though underlying medical conditions like diabetes or rheumatoid arthritis can increase the risk. Individuals with these conditions or those who engage in extensive manual labor may have a higher chance of recurrence.