Trigger finger describes the painful locking and clicking of the flexor tendon on the finger as it passes under the fibrous pulleys of the hand and finger. This condition is most commonly seen in patients from middle age and elderly patients. The onset is typically gradual and may start with a small painful bump at the base of the finger. Over time the finger may begin to click and eventually may becomes stuck fast in a flexed (bent) position.
Patients often describe waking in the morning with the finger bent down towards the palm of the hand which they then have to painfully pull on the finger to straighten.
Unfortunately, as the tendon and the pulley become more irritated and inflamed, moving the finger tends to cause further irritation. For this reason the condition often tends to worsen becoming more painful and causing more difficulties in functional use of the hand.
Fingers most commonly affected are the thumb, middle and ring finger. The condition is more common in patients with diabetes and other endocranial and metabolic disorders. It may be associated also with patients work (carpenter or electricians) or leisure activities (climbers or racket sports) which involve lots of gripping and strenuous activities using the hands and upper limb such as climbers. The first line of treatment might be activity modification in these cases, however even then symptoms can take a very long time to settle. Physiotherapy advised exercises and stretches can sometimes help, but unfortunately many patients find that their symptoms persist.
Treatment of Trigger Finger using Steroid Injections
Ultrasound guided steroid injection can be extremely useful for this condition. A small volume of corticosteroid can be deposited immediately adjacent to the area of thickening affecting the tendon and pulley. Studies show a very high success rate following just a single injection of corticosteroid in resolving this condition. Occasionally a second injection may be required, so we recommend leaving at least 4-6 weeks between these injections.
Some potential risks and side effects of steroid injections are listed here, and more information about the treatment can be found here. Because doses used for this condition are very low, the side effects are typically minimal. Because it is a superficial injection and we are injecting close to a tendinous structure we will advise you on the most appropriate corticosteroid in order to minimise risk to local soft tissue structures. There may be a risk of some temporary localised depigmentation (lightening of skin colour) and fat atrophy (dimpling cause by temporary thinning of fat just below the skin).
In order to book an ultrasound guided injection for trigger finger or trigger thumb please call 020 7482 3875. We do not require a medical referral. Patients may refer themselves, and we accept referrals from any other healthcare professional.
If you have have any further questions please do not hesitate to contact us on firstname.lastname@example.org.
By Clinical Director Dave Baker