Consultant – Gavin Brigstocke

What is a Trigger Digit?
Trigger digit is a painful condition in which the finger or thumb locks as it is bent in towards the palm. It is the result of thickening of the mouth of the tendon tunnel which results in wear and tear of the tendon and catching of the tendon as it is unable to glide through the mouth of the tunnel. Trigger digit may present with pain in the palm at the site of the triggering, clicking of the digit upon movement or locking of the digit in a flexed position, often worse in the morning. The digit may need to be straightened.

What treatments are available?
Non-operative measures include activity avoidance, the use of a small splint at night to hold the finger straight and administering a steroid injection. If non-operative measures fail and troublesome symptoms persist a surgical decompression of the tendon tunnel can be performed under local anaesthetic.

What are the outcomes?
A steroid injection relieves the pain and triggering in approximately 70% of cases. There are few risks associated with such an injection, but it may occasionally result in thinning or discolouration of the overlying skin. Surgery usually results in a rapid resolution of pain and triggering. The scar in the palm may be tender for several weeks and although uncommon triggering may recur.

Further information:
https://www.bssh.ac.uk/patients/conditions/18/trigger_fingerthumb