‍Understanding Trigger Finger

Trigger finger is a condition in which a finger or thumb catches or locks when bent. Though it often starts as a mild inconvenience—perhaps a slight soreness or clicking sensation—it can progressively lead to significant pain, stiffness, and a limited range of motion. When the thumb is specifically affected, this variant is known as trigger thumb.

At TMSC, our board-certified plastic surgeons specialize in diagnosing and treating trigger finger with the utmost care and precision. Whether you’re experiencing early signs or have dealt with chronic symptoms for months, we’re here to help restore your hand’s functionality and improve your quality of life.

The Anatomy Behind Trigger Finger

Your fingers bend and straighten thanks to a complex interplay of tendons, muscles, and bones. The tendons responsible for finger flexion slide through narrow channels known as sheaths. Within these sheaths, there are pulley-like structures (the A1 pulley, in particular) that keep tendons close to the finger bones.

• Tendons: Rope-like tissues that connect muscles in the forearm to the bones of the fingers.
• Sheaths: Protective tunnels through which tendons pass.
• Pulley: A band of tissue that holds the tendon in place, guiding its movement.

When these tendons become inflamed, irritated, or swollen, they can’t glide smoothly through the sheath. Inflammation and thickening of the tendon or the pulley itself cause catching or locking of the affected finger. Over time, the irritation can create a nodule (or lump) on the tendon, making it even harder for the tendon to slip through the tight pulley without getting stuck.Advanced Symptoms

In more severe cases, the finger can lock in a bent position and then pop straight unexpectedly—or remain locked entirely. These symptoms are often more pronounced after heavy hand use or following a period of inactivity (such as overnight).

• Locked in a Bent Position: You may need to use your other hand to manually straighten the stuck finger.
• Sudden Release: When the finger does straighten, it can do so with a painful jerk or snap.
• Inability to Straighten: In rare but serious cases, the finger may remain locked despite gentle manipulation.

If you’re experiencing these symptoms—especially recurring locking or persistent pain—seek professional evaluation. Early diagnosis is key to preventing long-term complications.

Causes of Trigger Finger

While the exact cause of trigger finger isn’t fully understood, several factors are associated with its development:

1. Repetitive and Forceful Hand Activities
   • Jobs or hobbies involving frequent gripping—such as gardening, construction work, or musical instrument play—can stress the tendons.
   • Over time, repetitive movements contribute to tendon inflammation.
2. Underlying Medical Conditions
   • Diabetes and rheumatoid arthritis are well-known risk factors for trigger finger.
   • In these conditions, chronic inflammation can thicken the tendon sheath, making it harder for tendons to move freely.
3. Hand Anatomy and Biomechanics
   • Some individuals may have a naturally narrower tendon sheath, increasing susceptibility to issues.
   • Past hand injuries can lead to scar tissue formation, further constricting movement.

How Inflammation Leads to Trigger Finger

When the tendon’s surface becomes irritated (often from overuse or minor trauma), it swells slightly. This swelling, combined with thickening of the sheath or pulley, restricts the normal sliding motion. A cycle of irritation can occur: the tendon swells → movement is restricted → further inflammation results.

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Benefits of Early Treatment

The good news is that trigger finger often responds well to early intervention:

1. Reduced Pain and Inflammation
   • Timely treatment can calm the irritated tissues quickly, preventing chronic flare-ups.
2. Prevention of Progressive Symptoms
   • Addressing the problem early can stop the condition from worsening to the point of locking or persistent stiffness.
3. Improved Finger Function and Flexibility
   • With early treatment, most individuals regain normal range of motion without permanent damage to tendons or pulleys.
4. Decreased Likelihood of Surgery
   • Many cases can be managed with non-surgical approaches if caught early, potentially sidestepping operative procedures.
5. Enhanced Hand Health
   • Taking proactive measures—like adjusting your activities or using ergonomic tools—can protect your hands and prevent future overuse injuries

Treatment Options for Trigger Finger

At TMSC, we offer specialized surgical treatment for trigger finger. When non-surgical treatments, such as steroid injections, fail, surgery becomes the next option. The surgical procedure, known as "tenolysis" or "trigger finger release," aims to release the A1 pulley that obstructs tendon movement, allowing the tendon to glide smoothly through the sheath. Local anesthesia is used to numb the area during the procedure.

Non-Surgical Treatment Options

Before recommending surgery, many medical professionals begin with less invasive interventions. These can be effective, particularly for mild to moderate cases of trigger finger:

1. Rest and Activity Modification
   • Temporarily avoiding activities that overstrain the affected finger (e.g., prolonged gripping or forceful pinching) can help reduce inflammation.
2. Splinting
   • Wearing a finger splint (usually at night) keeps the affected digit in an extended position, reducing repetitive bending stress.
   • Splints can also be used during daytime activities if necessary.
3. Steroid Injections
   • Corticosteroid injections near the A1 pulley can decrease inflammation and provide pain relief.
   • Relief can last several months, and in some cases, a single injection is sufficient to resolve the issue.
4. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
   • Over-the-counter or prescription NSAIDs may help to lessen pain and reduce swelling in the short term.
5. Physical Therapy or Occupational Therapy
   • Targeted hand exercises can strengthen supporting muscles and improve tendon glide.
   • Therapists may also teach you techniques for daily tasks that avoid overloading the affected finger.
6. Hot/Cold Therapy
   • Applying a warm compress before activity can encourage fluid movement and tendon flexibility, while ice packs post-activity can mitigate swelling.

If these measures fail or if symptoms are particularly severe, surgical intervention might be the best course of action.

Surgical Treatment Options

When is Surgery Necessary?

Surgery becomes more pressing when:

• Non-surgical treatments (like injections or splinting) fail to provide relief.
• The finger locks regularly, causing substantial pain and functional limitation.
• The patient’s overall hand function is severely compromised, affecting work, daily tasks, or quality of life.

Tenolysis (Trigger Finger Release)

The primary surgical procedure to address trigger finger is known as tenolysis or trigger finger release. During this operation:

1. Anesthesia
   • A local anesthetic is administered to numb the area. You remain awake, but you won’t feel pain in the treated finger.
2. Incision
   • The surgeon makes a small cut (often just a few millimeters) in the palm near the base of the affected finger.
3. Release of the A1 Pulley
   • The tight pulley (A1) is cut, creating more space for the inflamed tendon to glide without catching.
4. Tendon Inspection
   • The surgeon checks the tendon to ensure it moves smoothly through the sheath. In some cases, minor adhesions or nodules may be carefully addressed.
5. Closure
   • The incision is then closed with stitches, and a small bandage or dressing is placed. Some patients may only need skin glue or adhesive strips.

Surgery Details

• Surgery Cost: The cost of trigger finger surgery depends on factors like the surgeon’s expertise, the complexity of your case, and whether OHIP or private insurance fully covers the procedure. At TMSC, we provide a detailed estimate during your consultation.
• Recovery Time: Most people experience a relatively quick recovery—often returning to light activities within a few days. Full healing, especially for heavy manual labor or sports, can take several weeks to a few months.
• Anesthesia: With local anesthesia, you’ll be awake yet comfortable, minimizing risks associated with general anesthesia.
• Surgery Name: Medical terms for the procedure include tenolysis or trigger finger release.
• Post-Surgery Issues: While complications are rare, potential risks include infection, stiffness, or recurrence of symptoms. Our skilled surgeons at TMSC take every measure to minimize these possibilities.
• Success Rate: Trigger finger release has a high success rate, with most patients experiencing significant relief and improved finger movement soon after surgery.

Recovery and Aftercare Following Trigger Finger Surgery

Immediate Post-Operative Period

• Bandaging: You’ll likely leave the clinic with a bandage or light dressing around the surgical site.
• Pain Management: Over-the-counter pain relievers (like acetaminophen) or prescribed medication may be suggested for the first few days.
• Movement: Surprisingly, gentle finger movement is encouraged soon after surgery to prevent joint stiffness. However, avoid heavy gripping or strenuous tasks until cleared by your surgeon.

Weeks Following Surgery

• Stitches Removal: If non-absorbable sutures were used, they’re typically removed 1–2 weeks post-surgery.
• Hand Therapy: Some patients benefit from hand therapy sessions to regain strength, coordination, and full range of motion.
• Returning to Normal Activities: Many can resume light daily tasks within a few days, gradually advancing to more demanding activities over 2–6 weeks. Complete healing can take longer if the case was severe or if multiple fingers were treated.

Long-Term Considerations

• Scarring: A small scar may be visible in the palm, but it usually fades over time.
• Lifestyle Adjustments: If repetitive hand strain contributed to your condition, consider changing your ergonomics or using tools designed to reduce stress on your fingers.
• Recurrence: Although rare, trigger finger can recur if tendons become inflamed again. Preventive measures (like breaks during repetitive tasks) can help.

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Why Choose TMSC?

1. Board-Certified Expertise
   Our surgeons are not only specialists in hand surgery but also dedicated to safety and clinical excellence.
2. Cutting-Edge Techniques
   We stay updated on the latest research and methods in treating hand conditions. From advanced non-surgical treatments to minimally invasive surgical approaches, we focus on delivering optimal results.
3. Convenient Locations
   TMSC operates in Toronto, Vaughan, and Oakville, making it easier for patients across the GTA to access top-tier care.
4. Personalized Treatment Plans
   We believe in individualized care—tailoring our approach to your unique condition, activity level, and personal goals.
5. Patient-Centered Environment
   From your first consultation to post-operative follow-ups, our team is here to guide and support you every step of the way.

Insurance Coverage for Trigger Finger

In Ontario, treatment for trigger finger—including surgery—is covered by OHIP when deemed medically necessary. This coverage typically includes:

• Surgical fees
• Operating room costs
• Essential post-operative care

Non-surgical treatments, such as steroid injections or physical therapy, may involve additional costs depending on the setting and specific coverage details. At TMSC, our administrative team can help you navigate insurance paperwork, ensuring you understand what’s covered and what’s not.

Contact Us

For more information or to schedule a consultation, please visit our clinics in Toronto, Vaughan, and Oakville. We are committed to providing top-quality care for all our patients.

Our locaitons

• Toronto: 2920 Dufferin Street, Suite 202, Toronto ON M6B 3S8
• Oakville: 3075 Hospital Gate Unit 109, Oakville, ON L6M 1M
• Vaughan: 2701 Rutherford Rd Building C, Vaughan, ON L4K 2N6
• Mississauga: 1224 Dundas Street West  Unit 101 Mississauga, ON L4C 4G7