Trigger finger, also known as stenosing tenosynovitis, is a condition that makes finger or thumb movement difficult. It occurs when the tendon or its protective sheath in the affected digit becomes inflamed and thickened, impeding smooth gliding and potentially causing the finger to catch or lock in a bent position. When conservative treatments are no longer effective, surgery is often considered a common and effective solution to alleviate symptoms and restore normal finger function.
When Surgery Becomes an Option
Trigger finger symptoms frequently begin gradually, often following repetitive hand use, and can include pain, stiffness, and a locking sensation. Before considering surgery, healthcare providers typically recommend non-surgical approaches to reduce inflammation and improve movement.
Initial non-surgical options include resting the affected hand, avoiding activities that worsen symptoms, and using a splint to keep the finger straight, especially at night. Over-the-counter pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs), can help manage pain and inflammation. Corticosteroid injections, administered near the tendon sheath, are also a common first-line intervention.
Surgery becomes a consideration when conservative treatments fail to provide lasting relief or if symptoms are severe and significantly impair daily activities. Persistent pain, frequent locking, or a finger that remains stuck in a bent position are key indicators for surgical intervention. While steroid injections are effective for many, their efficacy can be lower in individuals with certain underlying health conditions like diabetes.
The Surgical Procedure Explained
Trigger finger surgery, often called a trigger finger release or A1 pulley release, corrects the issue at the A1 pulley, a band of tissue that holds the flexor tendons close to the finger bones. When this pulley becomes inflamed and thickened, it restricts the smooth movement of the tendon, causing the characteristic catching or locking. The surgery’s goal is to widen the passage for the tendon, allowing it to glide freely.
The procedure is typically performed as an outpatient surgery, meaning the patient can return home on the same day. It usually takes a short amount of time. Local anesthesia is administered to numb the hand, ensuring the patient does not feel pain during the operation. In some cases, a mild sedative may also be given to help the patient relax.
There are generally two main approaches: open release and percutaneous release. In an open release, a small incision is made in the palm, usually along a skin crease. Through this incision, the surgeon cuts the constricted A1 pulley, releasing the tendon. The percutaneous approach involves inserting a sturdy needle into the affected area to break apart the tissue blocking the tendon, without requiring an incision. This method is often done under ultrasound guidance to ensure precision.
Life After Surgery: Recovery and Care
Following trigger finger surgery, patients can expect some immediate soreness, swelling, and bruising in the operated hand. Pain management often involves over-the-counter pain relievers, and keeping the hand elevated above heart level can help reduce swelling. A soft dressing is typically applied to the hand, which may be removed after a few days.
Gentle movement of the operated finger is encouraged almost immediately after surgery to prevent stiffness and promote healing. Wound care involves keeping the surgical site clean and dry. If stitches were used, they may dissolve on their own or be removed by a healthcare professional within two to three weeks.
The initial recovery period for discomfort and swelling generally lasts several days to a few weeks. Full movement often returns within two weeks, though complete resolution of soreness and stiffness can take up to six months. Patients should avoid strenuous activities, heavy gripping, or lifting for a few weeks to allow the wound to heal properly and grip strength to return. A healthcare provider will provide guidance on when it is safe to resume daily activities, including driving and work. Some individuals may benefit from hand therapy or specific exercises to regain full range of motion and strength.
Potential Considerations and Outcomes
Trigger finger surgery is generally considered a highly effective procedure with a high success rate. Many patients experience significant relief from pain and improved finger function, with a low recurrence rate.
Some patients may experience persistent stiffness or scar sensitivity after surgery. While stiffness usually improves over time, some individuals might require hand therapy to regain full mobility. Other less common considerations can include infection, nerve damage, or incomplete release, where some triggering persists. Most patients achieve successful outcomes, with the benefits of restored finger movement and pain relief outweighing the risks.