Trigger finger is a very common condition that occurs with inflammation of the finger flexor tendon. The flexor tendons pull your fingers into the palm when you make a fist. Each of these tendons has a sheath around it that it moves through. This has been described as a tunnel in the finger. Normally, the tendon glides back and forth within this tunnel. Inflammation can develop at the opening of the tunnel. Overtime the tendon develops swelling and enlarges at this site. The gliding motion is lost and often the tendon becomes stuck in the tunnel. People notice this when they try to fully flex the finger. The finger can get stuck in the flexed position and clicks when straightened. This is called triggering. Overtime this becomes painful.
Some people can have resolution of the triggering with rest, splinting, and anti-inflammatory medications like Ibuprofen. When this is unsuccessful a corticosteroid injection given at the site of the triggering helps lessen the inflammation and swelling. Only about half of patients get improvement with the steroid injection. When triggering continues surgery is recommended. A small incision is made over the site of the triggering. The tunnel is identified while protecting nerves and arteries to the fingers. The opening of the tunnel is split with a scalpel. The tunnel then heals with a wider opening which allows the swollen portion of the tendon to glide normally again. This procedure is tolerated well and patients can continue to perform normal daily activities right away.