Lifestyle changes and activity avoidance are often effective treatments for trigger finger. Corticosteroid treatment may also be effective, but the symptoms may return after this treatment. According to a study published in the Journal of Bone and Joint Surgery , researchers found that symptoms had returned in 56 percent of patients by one year after receiving corticosteroid injection treatments. These symptoms typically came back several months after receiving the shot. However, the injection is quick and simple, and it can allow you to put off having surgery until a time that’s more convenient.
The scenario listed above points to a diagnosis of trigger finger. In this condition, the disparity in size between the flexor tendon and the surrounding retinacular pulley system, most commonly at the level of the first annular (A1) pulley, results in difficulty flexing or extending the finger and the “triggering” phenomenon. Metacarpophalangeal locking should be included in the differential, where the collateral ligament or volar plate tethers on a prominent metacarpal head or osteophyte.
The referenced text notes that a series of two corticosteroid injections should be given before surgery is considered for A1 pulley release. Mention is also made of the possibility of diabetics being more resistant to injections, with surgical release being a cost-effective treatment for this patient population.
Illustration A shows the clinical appearance of this disorder.
The bones in your fingers are known as phalanges and you have 14 in each hand. Each of your fingers have 3 phalanges, however your thumb only has 2. The muscles that allow for movement in our fingers are located in the forearm. We have long tendons that attach these muscles in our forearm to the bones of our fingers. These tendons are covered in a tunnel like structure of tissues, called a sheath. When you bend your fingers the tendons slide through the sheaths to keep them in place next to your bones. If you suffer from trigger finger the sliding of the tendons through the sheath is interrupted by inflammation of the tendons.