Trigger finger is where a finger in a gripping position appears to lock in place. When you pull the finger open, it unlocks with a click (or in my case a loud ‘clunk’ which made anyone around me squirm!), hence the name trigger finger. The condition is caused by a nodule growth on the tendon which gets stuck on the pulley (sheath) system that is there to guide/hold the tendon in place. Doctors have minimal knowledge about why this nodule forms. Nodules on tendons can come and go on their own, but this one has been bad and persistent.

The build up to the operation had certainly been playing on my mind for several months. Unsurprisingly the mental prospect of the surgery was the worst part since the operation itself was only 15min in duration and was carried out under local anaesthetic (although I avoided the temptation to watch it!).

The procedure itself involved cutting open the sheath(pulley) that was causing the tendon restriction to occur, which freed the movement of the tendon (and nodule). The surgical entry point was  on the palm of the hand just below the finger, and the incision itself was only about 1 inch long.

Recovery time has been fast. I am now nearly 3 weeks post op, the stitches are out , and the skin on the scar has fully healed over. I still have joint stiffness, and a bit of swelling which causes my finger to stiffen up in the bent position, but I expect this to gradually subside over time, especially after I keep stretching it like I have been instructed to do by the physiotherapists.

It is too early to do a complete assessment of the experience, but I can say that it’s great not having an annoying triggering finger condition any longer!

I wish there was a simple solution like this to my RSI condition!

UPDATE : 1 month post op

It’s now been about 1 month post operation, and I thought I’d update this post. Although the scar on the plam of the hand is healed over, however I still have a lot of  sensitivity about the entrance wound, as well as a lump under the wound. Not sure at this point if the lump is scar tissue or the nodule. The triggering has gone, but I still have a lot of stiffness in the joint, and the finger still likes to stick in the bent position (I have to physically bend it straight with my other hand). Hopefully this is just a result of the swelling and that this will go away on time. I am using the finger, but it can be sore depending on the task at hand.

Update: 2 1/2 months post op

The finger is getting  better all the time. It doesn’t stiffen up as frequently as before, but it still can stiffen quite badly and there is no cause I can determine for this. I recently had a follow up with the surgeon, and was advised that post op stiffness is common, and recovery can be as much as 18 months for some individuals – they don’t tell you that before the op! He suggested massaging the joint to reduce the swelling. The scar has totally healed up now, and is a whole lot less sensitive than it was a few weeks ago.

Update: 6 months post op

It’s certainly taken it’s time, but the finger is showing very little stiffness now. I can extend it fully contract it fully, grip things tightly, and have no sign of that horrible triggering any more. I can officially say the op was a success. It does go to show that there is a 3-6 month recovery term for this operation. Good luck with the operation if you are someone who is considering having it done and just factor in a few months for the recovery.

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• hot wax heating of the hands (you would be surprised how cold hands and arms get in air conditioned buildings)
• massage of the hands
• deep tissue massage of the forearm muscles
• ultrasound of the forearm muscles
• TENS stimulation of the arm nerves
• hot and cold contrast baths
• splints to minimise wrist deflection
• computer mouse modifications with stick-on foam to make them more comfortable to use
• pleasant demeanour of staff (made the visit that more enjoyable)

This compared with more lacklustre treatments in the past, where I received 5 minutes of ultrasound treatment followed by ‘here’s a splint to wear’. There’s a lot of knowledge to share in this regard by the physiotherapy profession, and hopefully in time that knowledge will propagate.

Physical therapy initially managed to get me back from the brink of not being able to work to being able to to work for a period of 18 months, before the symptoms started ratcheting upward again. The second round of physical therapy wasn’t as beneficial, I had tipped over the treatable ‘cliff edge’. Many times I would return from a physiotherapy session pain free and relaxed, only to jump back onto the computer that had worsened the symptoms, and within hours, be back in severe pain again. This was the problem in my experience with physical therapy. It was like being able to take a nice big pain relief tablet, only for it’s effects to wear off in a few hours.

The fact is that physical therapy can’t help cure your ergonomic problems; only you, armed with the correct knowledge, can do that. Physical therapy is however a great way to get symptomatic pain relief.

I did take something from the physical therapy treatment though. It taught me how much of my problem was down to ultra tight and possibly deformed forearm muscles. It also led me to being able to temporarily relieve the pain myself at home by using a combination of an arm massaging device, a TENS machine and hot and cold contrast baths on the forearms. This process was admittedly time consuming, but it did give me some much needed temporary pain relief.

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