Trigger Finger: Symptoms, Treatments, and Surgical Options

Trigger finger concerns?

Dear Director Chen,
I have trigger finger in both of my middle fingers.
I have already received a steroid injection in my right hand, but my left hand has not been treated yet.
Currently, both hands are painful, and I often experience sharp pain in the middle finger of my right hand and at the base of my palm.
The pain in my left hand may be due to incorrect pressure points caused by the discomfort, leading to pain in the muscle below my left thumb.
As I work in accounting and use a keyboard and calculator daily, I am considering minimally invasive surgery.
I would like to know if your hospital offers this procedure and whether it is covered by health insurance.
Which doctor should I consult for this issue? Thank you for your guidance.

Miss Zhou, 50~59 year old female. Ask Date: 2017/07/27

Dr. Chen Yongxue reply Orthopedics

Hello, if conservative treatment for trigger finger is ineffective, surgical treatment should be considered.
The surgical incision is relatively small, so there is no need to worry.
Our hospital is equipped for this procedure, and any orthopedic surgeon can perform it.
This surgery is done on an outpatient basis, so hospitalization is not required, but you will need to schedule an appointment in advance.
Please visit the outpatient clinic for consultation.
Thank you.

Reply Date: 2017/07/27

More Info

Trigger finger, also known as stenosing tenosynovitis, is a condition that affects the tendons in the fingers, causing pain, stiffness, and a locking or catching sensation when trying to straighten the affected finger. This condition can significantly impact daily activities, especially for individuals whose work involves repetitive hand movements, such as typing or using tools.

Symptoms
The primary symptoms of trigger finger include:
1. Pain and Tenderness: This is usually felt at the base of the affected finger, particularly when bending or straightening the finger.

2. Stiffness: The finger may feel stiff, especially in the morning.

3. Locking or Catching: The finger may lock in a bent position and suddenly snap straight, which can be painful.

4. Swelling: There may be noticeable swelling at the base of the finger.

Treatments
Treatment options for trigger finger vary based on the severity of the condition. They include:
1. Conservative Treatments:
- Rest: Avoiding activities that exacerbate the symptoms is crucial.

- Splinting: Wearing a splint can help keep the finger in a straight position, allowing the tendon to rest.

- Ice Therapy: Applying ice to the affected area can reduce swelling and pain.

- Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Medications like ibuprofen can help alleviate pain and inflammation.

2. Injections:
- Corticosteroid Injections: As you mentioned, you have already received a corticosteroid injection in your right hand. This treatment can reduce inflammation and swelling, providing relief from symptoms.

3. Surgical Options:
- If conservative treatments fail, surgery may be considered. The most common surgical procedure involves releasing the constricted tendon sheath to allow the tendon to glide freely. This is often done through a minimally invasive technique, which can reduce recovery time and minimize scarring.

Recovery and Rehabilitation
Post-surgery, rehabilitation is essential to restore full function. Physical therapy may include:
- Gentle stretching exercises to improve flexibility.

- Strengthening exercises to regain muscle strength.

- Gradual return to normal activities, ensuring not to rush the healing process.

Insurance and Healthcare Provider
Regarding your inquiry about insurance coverage, many health insurance plans, including Taiwan's National Health Insurance (NHI), typically cover surgical procedures for trigger finger if conservative treatments have been ineffective. It is advisable to consult with your healthcare provider or the hospital's billing department to confirm coverage details.

For your specific case, you should consult an orthopedic surgeon or a hand specialist who can evaluate your condition and discuss the best treatment options, including the possibility of minimally invasive surgery. They can also guide you on the necessary steps to take regarding insurance coverage and referrals.

Conclusion
Trigger finger can be a frustrating condition, especially for those who rely heavily on their hands for work. While conservative treatments can be effective, surgical options are available for those who do not respond to other therapies. It’s essential to seek professional medical advice to determine the best course of action tailored to your specific situation. Remember, early intervention can lead to better outcomes and a quicker return to normal activities.

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