Repetitive injury problems of the hand can manifest in several ways like carpal tunnel syndrome, Dequervain’s tenosynovitis and trigger finger. These entities share a common problem, a tight space around tendons. The space is defined by ligament called a pulley. Chronic pressure on the pulley causes swelling which then squeezes the tendon. In trigger finger, the tendon then swells and changes from a smooth cable to a cable with a knot that bumps up against the pulley. This knot can impede motion causing locking, pain and triggering.
Unlike carpal tunnel syndrome, splinting usually does not improve trigger finger. The problem is inflammation which can be decreased by a steroid injection. Although the steroid injection is easy and fast it only works about 50% of the time. If the injection fails or if you have severe or recurrent symptoms, surgery is the way to go.
Trigger finger surgery is done under local anesthesia as an outpatient. It takes about 15 minutes. The sutures are in for 10 days and most people don’t need to miss more than a few days of work.
