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Trigger finger

What is triggering?

Have you found that one of your fingers, or your thumb, gets uncomfortably stuck in a bent position and you need to free it with the other hand? If so then you may well be suffering from triggering. This condition results from the tendons becoming partially stuck underneath the pulleys which normally hold them next to the finger bones.

The ‘A1’ pulley is most commonly affected. You can feel this at the base of each finger in your palm. Usually the pulley becomes thickened followed by the tendon resulting in poor glide through the pulley tunnel. Often a vicious cycle of inflammation ensues.

What causes triggering?

To some extent the thickening is part of ageing but only about 10% of the population suffer with this condition. It can be associated with rheumatoid and osteoarthritis as well as gout, diabetes and following unaccustomed trauma to the palm but usually no cause can be identified.

What are the signs and symptoms of triggering?

A thick, tender nodule at the base of the finger or thumb with difficulty straightening the digit. The finger is often ‘stuck’ into the palm first thing in the morning. The problem may appear to arise from the joints further down the finger and they can also become stiff if the condition is not treated.

What is the treatment for triggering?

The Horder Centre has multiple means of treatment. If the triggering is mild then the use of an anti-inflammatory medication, either locally or orally may lead to spontaneous resolution. A local anaesthetic and steroid injection around the tendon will resolve the majority of resistant cases but a few require a small operation to release the A1 pulley. This is a local anaesthetic, day case procedure.

Information provided courtesy of our Consultant Orthopaedic Hand Surgeon, Mrs Lisa Leonard

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