Trigger Finger
Trigger finger is the popular name of stenosing tenosynovitis, a painful condition in which a finger or thumb locks when it is bent or straight...

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What Is Trigger Finger?

Trigger finger occurs when tendons in the hand become inflamed, causing tenderness, pain, and deformity in the hand. The condition limits a finger’s movement, making it impossible to straighten the finger.

What Causes Trigger Finger?

Your fingers have several small bones that are connected to muscles by tendons. When muscles contract or tighten, tendons pull on your bones to move your fingers.

Long tendons, called flexor tendons, extend from your wrist to the muscles and bones in your hands. Flexor tendons slide through a flexor sheath, which is like a tunnel for the tendon. If the tunnel gets narrower, your tendon cannot move easily. This is what occurs in trigger finger.

When the tendon slides through the narrowed sheath, it becomes irritated and swells. Motion becomes extremely difficult. Inflammation may cause a bump to develop, which further restricts movement. This causes your finger to stay in a bent position, and it is extremely difficult to straighten.

Who Is at Risk for Trigger Finger?

Some people are more likely to experience trigger finger than others. For example, it is more common in women than in men (American Academy of Orthopaedic Surgeons, 2010).

Other risks factors associated with trigger finger include:

  • being between the ages of 40 and 60
  • having diabetes, hypothyroidism, or rheumatoid arthritis
  • having tuberculosis
  • performing repetitive activities that can strain the hand, such as playing a musical instrument or repeatedly using hand tools

According to the Cleveland Clinic, trigger finger most commonly affects musicians, farmers, and industrial workers.

What Are the Symptoms of Trigger Finger?

Common early symptoms include:

  • lingering soreness in the base of a finger or thumb
  • a bump or lump around the base of a finger near the palm
  • tenderness around the base of a finger
  • a clicking or snapping noise with movement
  • stiffness in the affected finger

If left untreated, trigger finger can progress. Advanced symptoms include

  • a finger and/or thumb locked in a bent or straight position
  • being unable to uncurl the finger without using the other hand

Symptoms tend to be worse in the morning. The finger typically starts to relax and move more easily as the day goes on.

How Is Trigger Finger Diagnosed?

A doctor can commonly diagnose trigger finger with a physical exam and some simple questions about medical history.

The doctor will listen for characteristic clicking upon movement. They will look for the signature bent finger. The doctor may also observe you opening and closing your hand. Diagnosis will not typically require an X-ray or further imaging testing.

How Is Trigger Finger Treated?

Treatments depend on the severity of the symptoms. At-home treatments include:

  • taking a break from repetitive activities for four to six weeks
  • wearing a brace or splint to restrict motion and rest the hand
  • applying heat or ice to reduce swelling
  • placing the hand in warm water several times throughout a day to relax the tendons and muscles
  • gently stretching the fingers to enhance range of motion.

Medications may help relieve inflammation. Anti-inflammatory medications include: 

  • ibuprofen
  • naproxen
  • prescription strength anti-inflammatories
  • steroid injections

If medications and at-home treatments don’t work, a doctor may recommend surgery. Surgery for trigger finger is done on an outpatient basis. After an anesthesia shot, a surgeon makes a small cut in the palm and then cuts the tightened tendon sheath.

As the tendon sheath heals, the area is looser, helping the finger move more easily. Surgery risks include infection or ineffective surgery.  

Surgery recovery can take anywhere from several weeks to six months. A doctor may recommend physical therapy exercises to relieve post-surgery stiffness.

What Is the Outlook for Trigger Finger?

Lifestyle changes and activity avoidance are often effective treatments for trigger finger. Corticosteroid treatment may also be effective, but symptoms may return after this treatment. A 2008 study of corticosteroid injection treatments found that one year after the treatment, symptoms had returned in 56 percent of patients (Rozental, et al., 2008). These symptoms typically came back several months after receiving the shot.

The study also found that patients who had insulin-dependent diabetes, had several symptomatic fingers, and who were younger were more likely to have symptom recurrence.

Written by: Rachel Nall
Edited by:
Medically Reviewed by: George Krucik, MD, MBA
Published: Sep 30, 2013
Last Updated: Sep 30, 2013
Published By: Healthline Networks, Inc.
Sources:

●      Rozental, T.D., Zurakowski, D., & Blazar, P.E. Trigger Finger: Prognostic Indicators of Recurrence Following Corticosteroid Injection. (2008, August). The Journal of Bone and Joint Surgery. 90(8). 1665-1672. doi: 10.2106/JBJS.G.00693.
●      Trigger Finger (June 2010). American Academy of Orthopaedic Surgeons. Retrieved August 25, 2013, from http://orthoinfo.aaos.org/topic.cfm?topic=a00024
●      Trigger Finger. (2012). American Society for Surgery of the Hand. Retrieved August 25, 2013, from http://www.assh.org/Public/HandConditions/Pages/TriggerFinger.aspx
●      Trigger Finger. (2011, October 25). Mayo Clinic. Retrieved August 25, 2013, from http://www.mayoclinic.com/health/trigger-finger/DS00155/METHOD=print
●      Trigger Finger (2012, June 28). MedlinePlus. Retrieved August 25, 2013, from http://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000565.htm
●      Trigger Finger and De Quervain’s Disease. (2013). Cleveland Clinic. Retrieved August 25, 2013, from http://my.clevelandclinic.org/orthopaedics-rheumatology/diseases-conditions/hic-trigger-finger-and-dequervains-disease.aspx

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