Trigger finger trigger thumb help

I was just diagnosed with trigger thumb. My tendon is swollen and will only pass through the pulley closest to my wrist with a lot of effort and a lot of pain.

from the hand surgeon:

Plan A, inject Cortizone, wait two weeks, hope the inflammation goes down, all is well.  This has a 30% chance of success.  I had this done last week with little improvement so far.  

Plan B, do a second injection, but this is rarely successful if there were limited results from the first injection.

Plan C, do a trigger release, a minor surgery where he would cut the pulley. He claims this pulley does almost nothing for us. He would simply eliminate the pulley function allowing the tendon to move freely.  He has many climber patients and understands how important our fingers are to us.

Anybody with a similar experience/ advice?

Yes I know, getting medical advice on Mountain Project blah blah blah yada yada yada. Just seeking some opinions and information even if you are not a doctor. 

Sorry to hear you are having problems.
if it was me, I’d try one shot of cortisone.
You can always get surgery if it doesn’t work.
But if the trigger thumb is interfering significantly with work, then I’d just get surgery and be done.

Good luck!

Hi Greg,

I have the same thing on my left thumb. I opted to try the cortizone shot and got it about eight weeks ago and it has worked pretty well. It did take longer than 2 weeks for my thumb to be back to mostly normal, a month or more I'd say. I was not psyched on having my hand cut on and the shot was covered by my insurance so I went that route. Happy with the results so far, I would try the shot before surgery. Good luck man, that shit's painful!

I had the same problem a year ago, Saw a hand surgeon and he explained it the way you heard it, except I think he gave the first shot better than a 30% chance. 

Got the cortisone shot. Seemed better, then not. Eventually, the "popping" and trigger thumb went away. No second shot, no surgery.

Try the least invasive method (plan A) first.

Thank you all for the advice so far.  I opted for plan A last week.  No improvement yet.  I will wait another week or so before taking the next step.  It is quite painful and really interfering with work and play.  

I realize this is a month old, but if anyone still cares, I had a bad case of trigger thumb. I could straighten my thumb, or I could close it, but it took two hands to do it. Would not close on it's own. I like to draw, so, before I could grip my pen, I'd have to manually bend the thumb joint with the other hand into the position where I could hold the pen. Then I could draw fine. But it stayed bent until I grabbed it and opened it up. Think of a door that will open or close, but has to be forced into either position because some carpet underneath has a raised roll in the way of the door. 

My surgeon described it as a swollen tendon that has to pass under a pulley. Or as an overly high truck passing under  a freeway bridge that is slightly too low. It will pass under the bridge, but it will scrape badly.

In a 15 minute surgery with local anesthesia, he made a serious of very small cuts in the pulley, opening it wider. In the operating room, he held up my hand and told me to flex my thumb. It was perfectly, instantly fixed. He had "raised the bridge", so the truck could get under smoothly.

I was playing ping pong, drawing and climbing normally a week later. Three years later it is still great. 

Mark Websterwrote:

I realize this is a month old, but if anyone still cares, I had a bad case of trigger thumb. I could straighten my thumb, or I could close it, but it took two hands to do it. Would not close on it's own. I like to draw, so, before I could grip my pen, I'd have to manually bend the thumb joint with the other hand into the position where I could hold the pen. Then I could draw fine. But it stayed bent until I grabbed it and opened it up. Think of a door that will open or close, but has to be forced into either position because some carpet underneath has a raised roll in the way of the door. 

My surgeon described it as a swollen tendon that has to pass under a pulley. Or as an overly high truck passing under  a freeway bridge that is slightly too low. It will pass under the bridge, but it will scrape badly.

In a 15 minute surgery with local anesthesia, he made a serious of very small cuts in the pulley, opening it wider. In the operating room, he held up my hand and told me to flex my thumb. It was perfectly, instantly fixed. He had "raised the bridge", so the truck could get under smoothly.

I was playing ping pong, drawing and climbing normally a week later. Three years later it is still great. 

Thank you so much for your reply Mark. I am a procrastinator. So your post is still relevant.  

My case sounds nearly identical to yours. It is becoming quite painful.  I had to unlock it, lock you did, mid climb, on lead the other day.  I had an acupuncturist recommended to me.  He claims to have 50 successful treatments of this ailment. So I'm going to try that first first.  If that doesn't show results after a few treatments then I will pursue the surgery you had. Again, thanks for your post.

Greg Dwrote:

Thank you so much for your reply Mark. I am a procrastinator. So your post is still relevant.  

My case sounds nearly identical to yours. It is becoming quite painful.  I had to unlock it, lock you did, mid climb, on lead the other day.  I had an acupuncturist recommended to me.  He claims to have 50 successful treatments of this ailment. So I'm going to try that first first.  If that doesn't show results after a few treatments then I will pursue the surgery you had. Again, thanks for your post.

I had the same surgery at 5 years old (31 years ago), and it was very easy and successful. I imagine they've only gotten better at it. I'd definitely consider it a safe option if the acupuncture doesn't work (let us know if it does, I had no idea it was even an option).

My wife was incredulous that I was healed instantly. No PT afterwards or anything. Not even a scar. She's been going through a bunch of surgeries for rotator cuffs and weird hand surgeries. Takes a year to recover from her stuff. I feel very lucky, as that was the first time to go under the knife and it went flawlessly. Climbing seems to be really hard on the body as the decades add up. I'm sure my time is coming.