Trigger Finger: Treatment Options

Trigger Finger: Treatment Options

This video will provide an overview of nonsurgical and surgical treatment options for trigger finger. Trigger finger is a condition in which a pulley and tendon in the finger become inflamed and enlarged, restricting the ability of the tendons to glide beneath it and bend the finger efficiently. This issue most commonly occurs at the A1 pulley. This mechanical issue can create significant pain and dysfunction in the finger, leading the patient to seek expert treatment with a hand specialist.

Treatment for trigger finger typically begins with nonsurgical options if symptoms are mild to moderate. The goal of nonsurgical treatment is to reduce inflammation at the pulley and improve the mechanical gliding of the tendons beneath. Typical nonsurgical treatment options include: the use of anti-inflammatory medication to relieve pain and swelling; splinting of the finger in an extended position, which limits friction of the tendon through the pulley; and lastly, an injection directly into the sheath of the tendon. Steroid injections have been shown to be helpful, with up to 93% of patients seeing relief in their symptoms. Those with diabetes, multiple trigger fingers, or symptoms that have been present for longer than 6 months. May not see such great results with injections. Newer treatment options, such as biologic injections and shockwave therapy, are being studied as potential nonsurgical treatments. Hand therapy may also be advised for massage and exercises that encourage healthy tendon gliding.

If treatment without surgery fails to relieve trigger finger symptoms, surgical treatment will be discussed. The goal of surgical treatment is to release or open the inflamed pulley, allowing smooth movement of the tendons below. Release of the pulley is often performed with an incision and surgical scissors. However, it can also be done using a needle. Both techniques are highly successful, with greater than 90% resolution of symptoms.

In summary, trigger finger is a mechanical issue of the pulleys and tendons in the fingers. Treatment without surgery will be considered for mild to moderate cases and may involve anti-inflammatories, splinting, and/or injections. Treatment with surgery will be considered for more severe cases and requires the release of the pulley.