This common condition is caused by a small area of swelling or thickening on a tendon (flexor tendon) in the palm. The normal tendon slides back and forth through a series of narrow tunnels as the finger is bent and then straightened. The enlarged section of tendon is then not able to pass easily through the normally tighter areas and the finger will “catch” or “trigger” as it is bent and straightened.
Treatment is usually a single corticosteroid (cortisone) injection. This is curative in over ninety percent of cases except in diabetic patients where the success rate is only fifty percent. If the injection is not successful or if the problem returns several times, then a fairly simple procedure to open up one of the tight tunnels is done under a local anesthetic.
Frequently Asked Questions
What causes a trigger finger?
The thickening or swelling is usually caused by repetitive direct pressure on the flexor tendon from firmly grasping a tool or other object. A single direct injury to the palm may also cause sufficient swelling of the tendon.
Will the problem return after the injection?
This can frequently be prevented with proper changes in habits or tools. If the activity that originally caused the problem continues, the condition may return even if the corticosteroid injection was successful at first.
Is the injection dangerous? I have heard that a cortisone injection is harmful.
The type of cortisone injections that are done by a Hand Surgeon into a hand, wrist or elbow have their effects locally, at the site of the injection. The effects that some people associate with cortisone, weight gain, etc., are not caused by the local injection.
How many injections can I receive?
Up to three injections in the same area is generally considered to be the maximum. The injections should not be given within six to eight weeks of each other or a tendon rupture may result.