Trigger Finger: From First Click to Full Recovery
Trigger finger often begins with stiffness or a catching sensation when bending or straightening the affected finger. You might notice a popping or clicking sound during finger movement. As the condition progresses, the finger may lock in a bent position, requiring you to use your other hand to straighten it. Pain and tenderness at the base of the affected finger are common, especially in the morning.
Initial home remedies for trigger finger include resting the affected hand, avoiding activities that require repetitive gripping, and applying ice to reduce inflammation. Over-the-counter pain relievers like ibuprofen can help manage discomfort. Gentle finger stretches and massage may also provide some relief. Wearing a splint at night to keep the finger straight can prevent morning stiffness.
If symptoms persist for more than two weeks despite home remedies, or if you experience frequent locking of the finger that interferes with daily activities, it's time to consult an orthopedic surgeon. Severe symptoms, such as the inability to straighten the finger at all, warrant immediate medical attention.
Conservative treatments prescribed by an orthopedic surgeon typically include custom-fitted splints to keep the affected finger in an extended position, especially at night. Corticosteroid injections into the tendon sheath can reduce inflammation and are often highly effective. Physical therapy exercises to improve finger flexibility and strength may also be recommended.
Conservative treatments are usually tried for 4-6 weeks. If symptoms don't improve after one or two corticosteroid injections, or if they recur shortly after treatment, your orthopedic surgeon may consider surgical options. Some patients may undergo conservative treatment for up to 3 months before considering surgery.
Surgery may be indicated if conservative treatments fail to provide lasting relief, if you have recurrent symptoms after multiple steroid injections, or if the finger remains locked in a bent position. Persistent pain and inability to perform daily tasks due to trigger finger are also indicators for surgical intervention.
The main surgical option for trigger finger is a procedure called trigger finger release. This can be performed as an open surgery or percutaneously (through a small incision). Both techniques aim to release the A1 pulley, allowing the tendon to glide smoothly. Your surgeon will discuss which option is best for your specific case.
The prognosis for trigger finger release surgery is excellent. Most patients experience complete resolution of symptoms and return to normal finger function. However, in rare cases, particularly if the condition was severe or long-standing before surgery, some stiffness may persist.
The complication rate for trigger finger release surgery is very low, typically less than 3%. Potential complications include infection, temporary numbness, persistent stiffness, and in rare cases, bowstringing of the tendon. These risks are generally outweighed by the benefits of surgery for appropriate candidates.
Recovery time is relatively quick. Most patients can move their finger immediately after surgery and return to light activities within a few days. Full recovery, including regaining complete strength and range of motion, typically occurs within 2-4 weeks. Some patients may require hand therapy to optimize recovery.
A successful outcome is typically defined as complete resolution of triggering or locking, elimination of pain, and full restoration of finger mobility and function. Most patients (over 90%) report satisfaction with the results of trigger finger release surgery, with a low recurrence rate and the ability to return to all normal activities without limitations.