A trigger finger or thumb causes pain at the base of the digit, and may also result in locking--triggering--in a flexed position. 60-70% of the time a single cortisone shot will cure the problem. Usually I will see you back in 4-6 weeks, and if your pain is not completely better, I will offer you a 2nd injection. A recent paper in the Journal of hand surgery actually suggested that as many as 5 injections may, at times, result in a cure if the 1st few do not. As a general rule, however, if the 1st two do not work, it usually means that surgical release of the A-1 pulley will be necessary. This is a 5 minute procedure and can be done under a local, with or without sedation--depending on you preference. You will remove your dressing in 2 days and place a bandaid, and your sutures will be removed in 2 weeks.
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Trigger Digit
This condition may be caused by overuse or repetitive use of the hand. Normally, as a finger is bent and extended, the finger's flexor tendons glide smoothly through a series of fibrous tunnels in the finger and hand. Trigger digit results from a narrowing of the fibrous tunnel in the palm called the first annular (or A1) pulley.
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Trigger Digit Release
During this minimally-invasive procedure, the surgeon opens a narrowed tendon pulley at the base of the finger or thumb affected by trigger digit. Opening the pulley prevents the nodule from catching, allowing the affected digit to flex and extend normally with no triggering or pain.
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