Offices in Berkeley Heights, Livingston, and Morristown, NJ

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Trigger Finger Treatment

One of the most common hand problems, trigger finger is a form of tendonitis of the finger flexing tendons.

Overview

One of the most common hand problems, trigger finger is a form of tendonitis of the finger flexing tendons. It involves the tendons and pulleys that bend the fingers. The tendons must glide along a series of pulley rings with a slick lining. If the pulley at the base of the finger becomes tight, the tendon cannot move freely. This leads to tendon swelling, catching, and locking, as well as problems with the use of the finger.

The exact cause of trigger finger is not clear. In some patients, it may be due to injury, may result from a cyst, or may be associated with medical conditions such as diabetes or rheumatoid disease. In the majority of patients, however, it’s just a matter of chance.

Trigger finger symptoms include:

  • Pain or swelling at the base of the finger near the knuckle
  • Catching, locking, or popping in the finger
  • Difficulty with gripping
  • Stiffness of the finger

For first-time patients, surgery is not recommended, and the condition is usually treated non-surgically. For those with a repeat case, a simple outpatient surgical release can be performed to relieve the pain and allow the finger to move again easily.

Your Consultation

Your Trigger Finger Consultation at Summit Medical Group

When you meet with us for your trigger finger consultation, the first consideration is a proper diagnosis. We will ask about your symptoms, prior injuries, pain patterns, or activities that aggravate the condition. If you are found to have trigger finger tendonitis, we will then devise a treatment plan for you.

If we determine your problem is a first-time trigger finger, we usually recommend rest, Motrin (if you can tolerate it), and sometimes a brace. In most cases, we also recommend a simple cortisone injection to break the inflammation cycle and the tendonitis. The injection is done during your visit in the office, after which most patients find relief from their symptoms in 3-5 days.

For repeat cases, we usually recommend surgery, since having trigger finger a second time in the same finger usually means it will be a lifelong problem until it is surgically released. If surgery is to be performed, we will provide you with written information about how to take care of yourself after the surgery, and we will answer any questions you have.

At Summit Medical Group, the patient experience is of primary importance to us. We customize every single procedure we do so that it is tailored to what is best for you.

Hand Surgery

Plastic Surgeons and Hand Surgery

Just like orthopedic surgeons, all plastic surgeons train in the surgery of the hand. In fact, historically, the origins of hand surgery involved more plastic surgeons than orthopedic surgeons, but over time, orthopedic surgeons have surpassed plastic surgeons in number in the USA. Some plastic surgeons and some orthopedic surgeons choose to specialize and focus on hand surgery. Not all plastic surgeons and orthopedic surgeons specialize in hand surgery. In our practice, Drs. Momeni and Schmid specialize in hand surgery across multiple offices.

Treatment Options

Non-Surgical Treatments for Trigger Finger

Patients who think they have trigger finger (based on symptoms) usually try the basic treatments before seeing a hand specialist. The goal of treatment is to reduce the inflammation and swelling in the pulley and tendon. Non-surgical interventions include:

  • Rest in a finger brace or splint for 1 week
  • Oral anti-inflammatory medication such as Aleve, Motrin, or Advil for 1 week
  • Cessation of causative activities (repeat activities such as knitting, gripping, and pressure)

For those patients who try the above and do not get relief, we confirm the diagnosis, and if we suspect trigger finger tendinitis, we proceed as follows:.

  • Cortisone (steroid) injections. These injections are the most effective of the non-surgical treatments, the effects of which can last about 6 months. Although rare, some patients are allergic to steroids. In diabetics, steroids can raise glucose levels. If you have diabetes, you can have the injections, but you must carefully watch your glucose levels for a few days.

It’s possible that you will have complete relief from a steroid injection. If your symptoms never return, there’s no further treatment needed. If, however, you develop a repeat case of triggering in the same finger, surgery is recommended to permanently release the lock on your finger.

What to Expect

What to Expect from Trigger Finger Surgery

The goal of surgery is to open the tight pulley, and to remove a cyst, if found. The operation can be performed on an outpatient basis and takes about 30 minutes. You may choose local anesthesia (awake, in our office) or twilight anesthesia (light sedation sleep, in a certified surgery center).

During surgery, a small incision is made at the base of the finger to open the tight pulley. A light gauze bandage is placed on the incision site for 1 night only, and you can remove it the next day.

Your Recovery

Recovering from Trigger Finger Surgery

We will ask you to keep your sutures clean and dry (with a waterproof Band-Aid), but no limits on movement are placed after trigger finger surgery. Most patients do experience some movement limitations from the discomfort of surgery, but you can resume activities as your comfort permits.

The sutures are removed after 2 weeks, so most patients return to work as soon as they feel comfortable after surgery (even with sutures). To prevent infection, the incision and sutures must be kept clean and dry for 2 weeks. You may clean the incision with alcohol or hydrogen peroxide, but you must avoid wetting it and getting water into the incision.

After surgery, therapy with a certified hand therapist is recommended for a few visits to regain motion quickly and build strength. While some patients have immediate and complete relief right after surgery, most patients experience some tenderness, swelling, and discomfort for several weeks near the incision. Pain medication can be taken to manage these symptoms. It is important to understand that the longer the finger tendon has been inflamed before surgery, the longer it will take after surgery to lose its swelling and inflammation.

In time, once the sutures are removed and the incision heals, the vast majority of patients will have permanent relief and no future issues. Trigger finger surgery is successful in more than 95% of patients.  No follow-up visits are needed unless significant symptoms remain after 3 months.

Doctors

Momeni, Reza

Dr. Momeni

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Pyo, Daniel J.

Dr. Pyo

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Schmid, Daniel , B.

Dr. Schmid

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