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Trigger finger

Also known as trigger digit or stenosing tenosynovitis

Key points about trigger finger

Trigger finger is a common hand condition causing pain or reduced movement of a finger that tends to catch, snap or lock.
It can be hard to bend (flex) or fully straighten (extend) the finger.
It's called trigger finger because when your finger unlocks, it pops back suddenly, as if releasing a trigger on a gun.
The cause is not totally clear. It can be more common in people with other conditions such as diabetes or rheumatoid arthritis.
Trigger finger is more common in the right hand and most often affects your thumb, ring finger or little finger.
Self-care may work but if not your healthcare provider may recommend steroid injections or surgery.

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Tendons are tough fibrous cords that connect your muscles to your bones. They are covered by protective sheaths that lubricate the tendons so they move freely when you move your body.

If the tendons or sheaths swell or become inflamed, the tendons can thicken and nodules form at the end of your palm. When you increase your finger movements, such as in repetitive gripping, the tendons tend to rub more. This worsens the thickening and makes the nodules bigger. Eventually, the thickening and nodule size increase so much that your finger gets caught in a locked position when you bend it.

The cause of this is not totally clear, but factors that increase your risk include:

rheumatoid arthritis
amyloidosis
diabetes
carpal tunnel syndrome
gout
underactive thyroid
Dupuytren disease
De Quervain’s tenosynovitis
people on renal dialysis
using your hand a lot at work, such as for screwdriving or using tools that press on your palm
previous hand injuries.

Common symptoms of trigger finger include:

a lump or nodule appearing in your palm
pain when you move your finger or press on it
catching or popping on bending or straightening your finger.

The triggering may be more obvious at night and in the morning, or while gripping an object firmly. It usually affects your thumb, little finger or ring finger, although more than one finger may be affected at a time.

Video: Trigger Finger: Symptoms and Anatomy

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(The Hand Society, US, 2015)

Your doctor will usually be able to diagnose trigger finger by taking a history and doing a physical examination. A history might include asking questions about any other health conditions and your work, as well as your symptoms, when they started and when the triggering happens.

Usually the initial treatment includes the following:

rest
avoiding activities or movements that make the pain worse
avoiding prolonged, repetitive or strong gripping of objects
avoiding extreme bending of the finger
avoiding gripping of equipment or tools that are narrow and slippery as they require more force to hold onto
pain relief
anti-inflammatory medication, such as NSAIDs
use of a splint to keep the finger in a neutral, resting position.

If those measures have been tried and haven't not been successful, treatment such as steroid injections or surgery may be recommended.

Steroid injections

Steroid injections involve the injection of cortisone medications such as triamcinolone, dexamethasone or methylprednisolone directly into the tendon sheath to reduce inflammation (swelling) and pain. You may need to use a finger splint to help rest the finger for a few days after the injection. Steroid injections are usually effective. However, it will take a few days to a few weeks for the steroids to work.

Surgery

Surgery will only be recommended after 2 unsuccessful steroid injections or for people with severe symptoms. You will be referred to a plastic or orthopaedic surgeon. Surgery for trigger finger is done under local anaesthesia. A cut is made through the tendon sheath to widen it so that your finger can move freely again.

Talk to your doctor to find out which treatment is the best for you.

Apps reviewed by Healthify

You may find it useful to look at some joint and bone health apps.

Some people may recover by themselves without needing treatment. However, there is a possibility your finger will become permanently bent if it is not treated.

Steroid injections have been shown to be effective in up to 75% of people with trigger finger. Sometimes, the condition can return after the injection and you may need a second injection.

Surgery has been shown to be effective and it is rare for the condition to come back. However, surgery is only needed if other treatments do not work.

Tendinitis
Hand and wrist conditions

Trigger finger overview(external link) NHS Choices, UK
Trigger finger(external link) American Academy of Orthopaedic Surgeons
Steroid injections(external link) HealthInfo Canterbury, NZ
Trigger finger(external link) HealthInfo Canterbury, NZ
Trigger finger(external link) Patient Info, UK