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Trigger Finger / Thumb

Stenosing synovitis, or trigger finger / thumb, involves the pulleys and tendons in the hand that bend the fingers. When the pulley at the base of the finger or thumb becomes too thick, because of arthritis, trauma, or some other reason, for the tendon to move easily through the pulley, the tendon lining may swell or develop a nodule. This increased resistance then causes pain, catching, popping, or even locking of the finger. More inflammation occurs, which leads to more swelling and inflammation.

Trigger finger and trigger thumb can be treated conservatively with splinting and oral anti-inflammatories to reduce swelling and thus improve the glide of the tendon through the pulley. Steroid injections into the flexor tendon sheath are often effective, as well. If conservative treatment does not work, outpatient surgery may be performed to open the pulley at the base of thethumb so the tendon may glide easily. Patients usually have active finger motion immediately after surgery, and begin normal use of the hand as tolerated. Some patients may require a course of hand therapy to regain normal use of their hand.