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  • Sim Chin Seng

Understanding What is a Trigger Finger and Its Causes

“Trigger Finger” or “Trigger Thumb” is a condition that causes your finger(s) or the thumb to get stuck in a bent position. Those with trigger finger or trigger thumb may experience stiffness when bending the finger(s) or hearing a “Snapping and Popping” sound whenever moving the finger(s).

Trigger finger is also known as “Stenosing Tenosynovitis” (stuh-NO-sing ten-o-sin-o-VIE-tis). This occurs when the inflammation of the Tendon narrows the space within the Sheath (Tunnel) that surrounds the tendon in the affected finger. If the trigger finger condition is severe, your finger may become locked in a bent position and is unable to straighten up on its own without your help in pulling the finger back into its position.

What Causes the Finger(s) or Thumb to remain in a “Bent Position”?

Tendons, which are actually bands of tissue that attaches muscles to bones. In the hand, the Tendons and Muscles must work together in order to flex and straighten your fingers or your thumb. Usually, the Tendons slides easily through a “Tunnel” of tissue called a “Sheath”. The Sheath keeps the tendons in place next to the bones of the finger(s) or the thumb. With “Trigger Finger” or “Trigger Thumb”, the Tendons become irritated and swollen (inflamed) and can no longer easily slide through their Sheaths. Prolonged irritation of the Tendon Sheath can produce scarring, thickening and the formation of a “Bump (Nodule) in the Tendon that impede the Tendon’s motion even more, which makes it even more difficult for the Tendon to easily glide through its Sheath resulting in your finger jamming in a “Bent Position”.

What are the Signs and Symptoms of A “Trigger Finger” or “Trigger Thumb”?

Some of the signs and symptoms of a Trigger Finger or a Trigger Thumb includes:

  • A Snapping or Popping sensation when moving the finger(s) or the thumb.

  • Soreness at the base of the finger or the thumb in the palm, especially whilst performing the Gripping or Grasping action.

  • Pain and stiffness when bending the finger(s) or the thumb.

  • Swelling or tender lump in the palm of the hand.

  • Locking of the finger(s) or the thumb in the bent position (in severe cases). The finger(s) or thumb must be gently straightened with the help of the other hand.

  • Inability to fully flex the finger or the thumb.

The stiffness and the bent position of the finger(s) or the thumb are usually worse in the morning. The stiffness lessens as the fingers and the thumb are used.

What are the Treatment Options Available for Those Suffering from Trigger Fingers?

Most Doctors will usually recommend treating Trigger Finger(s) through non-surgical means first when a person first started having such problems with this condition. People can try some of these methods at home according to Western Medical Practitioner. They include:

(1) Resting and Minimising the Use of their Hands

As Trigger Finger usually can result from overuse, simply resting the affected hand and finger can often reduce some of its symptoms. People may need to rest this part of the body for aperiod of more than 2 weeks to be able to see any tangible results.

(2) Taking over-the-counter Medications

Taking Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), such as ibuprofen and naproxen, may help to reduce the pain and the inflammation from trigger finger.

(3) Use of Trigger Finger Splints

A Trigger Finger splint usually wraps around the palm and has a small covering for the lower portion of the affected finger. This splint allows a person to bend the top portion of their finger without moving the part closest to the palm.

(4) Exercising the Hand and Finger

Hand and finger exercises can help to stretch and strengthen the muscles around the tendons of the fingers, which may help reduce the stiffness and pain. However, it is important to avoid overexercising and to discontinue any exercise that increases pain.

(5) Applying Ice to the Affected Fingers

Applying a cloth covered ice pack to the affected finger and palm for about 10 to 15 minutes at a time may help reduce some inflammation. A person should try to ice their finger between three and five times a day.

(6) Using Adaptive Tools

Placing of protective, soft-grip covers over car steering wheels, power tools, bicycle handles, and even pens can help reduce the effects of friction and potentially lessen the inflammation that leads to trigger finger.

(7) Getting Steroid Injections

The Doctors can inject Corticosteroids around the Tendon Sheath in the affected finger. These drugs may help to reduce the incidence of trigger finger pain and limits the impairment of movement. Sometimes, a person may require two or three injections to experience some form of symptom relief.

(8) Surgery

After a person tried the nonsurgical treatment methods and still continues to experience trigger finger, the medical doctor will often recommend surgery. The medical doctor is also likely to recommend surgery if a finger or the thumb becomes permanently “caught” or to become temporarily “stuck” in a bent position, he may then recommend a procedure to physically release the constricted Tendon Sheath causing the problem. Freeing this soft tissue will allow the finger or thumb to move freely again.

A release is done using Local Anesthesia and can be performed by piercing the skin with a needle (Percutaneous Release) or by making a Surgical Incision. These procedures are usually considered relatively low risk by the Western Medical Practitioners and are described in detail below.

There are three types of surgery that could be performed for trigger finger:

(a) Open Surgery

An alternative to the Percutaneous Release is that of an Open Surgery, which requires the Surgeon to make a small incision in the palm of the hand and then cuts the Tendon Sheath to give the tendon more room to move. The surgery, known as “Trigger Finger Release”, is usually done as an Outpatient Procedure and takes about half an hour to perform. It can take much longer if there are more than one finger to be released. The Surgeon will use stitches to close the wound. The patient will typically be given a Local Anesthetic so that he will not feel much pain.

Here is a step-by-step description of trigger finger surgery:

- The surgeon administers a local anesthetic and, once it takes effect, makes a small incision in the palm of the hand. For trigger thumb, the incision is in the pad of the thumb.

- The Surgeon then locates the Tendon Sheath and carefully cuts through it to make more space for the tendon.

- Before concluding the procedure and closing the wound, the Surgeon may flex and extend the affected finger to make sure the tendon can move freely.

Once the anesthesia wears off, the finger should be able to move normally right away.

The risk for complications or revisions after surgery is usually minimal. Approximately 97% of the patients are likely to have complete resolution of their symptoms after the procedure.

Open Surgery of Trigger Finger (Picture 2)

Open Surgery of Trigger Finger (Picture 3)

(b) Percutaneous Release Surgery

This surgery is also done using a Local Anesthetic. A surgeon inserts a needle into the bottom of the digit to cut the Tendon Sheath. This type of surgery does not leave a wound.

Percutaneous means through the skin, and this in-office procedure uses a needle to treat the affected Tendon Sheath tissue. Research suggests it has similar results to the Open Surgery method.

- The Surgeon administers a Local Anesthetic, typically “Lidocaine”.

- The Physician uses Ultrasound Imaging to carefully guide the needle to the affected Tendon Sheath and avoid damage to the tendon or nearby nerves. Most Physicians will use a 16- or 18-gauge needle, which is about the size of needles used for blood donation.

- The needle is used to break up constricting tissue around the Tendon Sheath.

- Because no incision was made, therefore no stitches were needed after the procedure.

However, not all the Physicians choose to use or are adequately trained to use Ultrasound Imaging during such a procedure.

Traditionally, Percutaneous Release Surgery has been less popular than the Open Surgery (described above), because Open Surgery gives the Surgeon a clear view of the affected tissues. Most physicians have been concerned that Percutaneous Release Surgery increases the risk of damaging unseen tendon tissues as well as the nearby nerves, which may be 2mm or 3mm away from the affected tendon. Those Physician who are trained to use Ultrasound Imaging to guide a needle during this procedure may reduce the likelihood of damaging the nearby nerves and tendons.

The Recovery Period from such Percutaneous Release Surgery is typically shorter than for that required by Open Surgery, thereby allowing the patients to return to work much sooner.

(c) Tenosynovectomy

The medical doctor will only recommend this procedure if the first two options were not suitable, such as in the case of people with Rheumatoid Arthritis. A “Tenosynovectomy” procedure involves removing part of the Tendon Sheath, thereby allowing the finger to move freely again.

Tenosynovectomy of the 4th Extensor Compartment

– Tendon Debridement

Tenosynovectomy of the 4th Extensor Compartment

– Tendon Debridement

(2 weeks Post Operation)


Having read through the entire article on Trigger Finger or Trigger Thumb so far, you will realised that the Western Medical Practitioner’s approach to the treatment of Trigger Finger is very invasive and may even likely caused you some damages to your Pulley (Tendon Sheath) and even some of the muscles and nerves around the affected finger. So it is therefore very important that you seek our treatment BEFORE you accept to go for those Surgery which a cause some form of irreversible nerves and muscles damage.

It was because of such devastating damages that Mr. SIM saw over the years of clinical practice, where these patients who came to see him with such irreparable and permanent damage to their fingers, nerves, muscles and hand through such surgical procedures (some of which had even gone awry and the patients remained permanently in the “bent” position) that our Consultant Therapist, Mr. SIM CHIN SENG had worked tirelessly in devising and even perfecting an unique and specialized treatment procedure that is completely non-invasive and safe; yet achieving successful results in Treating Trigger Finger and Trigger Thumb conditions that is ‘unseen’ and ‘unheard’ of in the industry. For those patients who came to see him before they accepted to go “under the knife”, most of them had ended up having their Trigger Finger problems completely treated and resolved by him such that they no longer need to go for those horrific surgeries.

If you are one of those ‘unfortunate’ people currently suffering from such Trigger Finger or even with the condition called the Carpal Tunnel Syndrome problems which nobody had been able to treat so far, you SHOULD book an appointment to see out Consultant Therapist. You will clearly not regret having taken such a course of action because this very action you are about to take could literally save your entire hand from the ‘possible’ untold damages. Furthermore, such surgical procedures could actually be circumvented using our unique treatment method pioneered by Mr. Sim in almost all the cases.

Thousands of his patients have benefited from Mr. Sim’s Treatment methodology over the years without the need to ever going for any such ‘unnecessary’ surgeries.

Call @ 6983 4964 or WhatsApp to @ 81200830 to book your appointment with our Consultant Therapist now. Please expect a short waiting period of few days due to the limited number of patients our Consultant Therapist can treat in a day. He is well known for giving his patients the permanent cure in the shortest possible time. His reputation in the industry is well known for his targeted treatment approaches which aims to give the patient a permanent cure for their conditions.

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