Meredith Larsen, MD, a hand surgeon with The Everett Clinic discusses trigger finger.


So trigger finger is a common condition
that we see in our hand surgery clinic. It’s typically when there are some
swelling around one of the tendons in the hand. And some thickening in one of the pulleys that that tendon runs through. So the tendons getting caught up on that
pulley and it can be quite painful for the patient. There’s some inflammation and
swelling that goes on there. So the patient notes notices that
when they’re flexing their fingers and moving their hand, that tendon gets caught up in can cause some clicking
initially at first and then sometimes it actually triggers or the tendon catches on that pulley and so the patient notices when they bendthe finger down, the finger doesn’t
always straighten very smoothly. It kind of catches as they try to extend or
straighten the finger. At times patients often complain
that they wake up in the morning and their finger’s actually stuck down in the flex position. Part of the
pathophysiology of that is just thickening of this pulley that the tendon runs through. That can just be a function of age.
Sometimes there’s swelling around the tendon for other reasons. And it can be related to other disease
processes. Patients who have diabetes, for example,
can be at a little bit elevated risk for that. But often times it
doesn’t seem that there’s really any particular one risk factor
at all. When a patient comes in with trigger finger very early on sometimes we can do to
just some simple splinting for it to give the tenant some
rest and allow some of that swelling and inflammation to calm down and that can
take care of the problem. If it’s been going on for a little bit
longer, I often recommend an injection, a steroid injection, into the
area around the tendon which also is a strong
anti-inflammatory medicine that we put right at the spot where the problem is going on, again to decrease the swelling in the
inflammation around the tendon and to help that tendon start to glide smoothly again with finger motion. We have lots of success treating trigger
finger. The vast majority of the time with an injection we can get people
fully cured. If that’s not the case, we can treat it very well with surgery.

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