Trigger finger is a painful condition that causes your fingers or thumb to catch or lock when you bend them. It can affect any finger, or more than one. When it affects your thumb, it’s called trigger thumb.
Most of the time, it comes from a repeated movement or forceful use of your finger or thumb. It can also happen when tendons -- tough bands of tissue that connect muscles and bones in your finger or thumb -- get inflamed. Together, they and the muscles in your hands and arms bend and straighten your fingers and thumbs.
A tendon usually glides easily through the tissue that covers it (called a sheath) thanks to the synovium, a lubricating membrane that surrounds joints. Sometimes a tendon gets inflamed and swollen. Prolonged irritation of the tendon sheath can lead to scarring and thickening that affect the tendon's motion. When this happens, bending your finger or thumb pulls the inflamed tendon through a narrowed sheath and makes it snap or pop.
Things that make you more likely to get trigger finger include your:
- Age: It usually shows up between ages 40 and 60.
- Gender: It’s more common in women than men.
- Health conditions: Diabetes, gout, and rheumatoid arthritis can cause trigger finger.
- Job: It’s common among farmers, industrial workers, musicians and anyone else who repeats finger and thumb movements.
You might notice:
- A painful clicking or snapping when you bend or straighten your finger. It’s worse when your finger’s been still, and it gets better as you move it.
- Stiffness in your finger, especially in the morning
- Soreness or a bump at the base of the finger or thumb. Your doctor will call this a nodule.
- A popping or clicking as you move your finger
- A locked finger that you can’t straighten
Symptoms often start out mild and become more severe over time. It’s more likely to affect you after a period of heavy hand use than an injury. It’s often worse:
- In the morning
- When you grasp something firmly
- When you try to straighten your finger
Your doctor will start with a physical exam of your hand and fingers. The finger may be swollen, stiff, and painful. You might have a bump over the joint in the palm of your hand. Or it could be locked in a bent position. There are no X-rays or lab tests to diagnose trigger finger.
It depends on how severe your symptoms are. Most of the time, you’ll start with:
Rest: Try not to move the finger or thumb. You may need to take time away from the activity that’s causing the problem. If you can’t quit, you might try padded gloves.
Splint: The doctor can give you one designed to keep your finger still.
Steroid Injections: She might give you a steroid shot into the tendon sheath. It can keep your symptoms at bay for a year or more, but it might take two shots to get results.
Surgery for Trigger Finger
If you have severe symptoms or if other treatments don’t work, your doctor may suggest a procedure. There are two types:
Percutaneous release: Your doctor will numb the palm of your hand then insert a needle into the area around the affected tendon. She’ll move the needle and your finger to loosen the tendon and make it work smoothly. She’ll probably do this in her office. She might use ultrasound so she can see where the tip of the needle is. This will help make sure she doesn’t damage your tendon or nearby nerves.
Surgery: She’ll make a small cut at the base of the finger and open the sheath around the tendon. This will probably take place in an operating room.
The time it takes to get better depends on how bad your condition is. The choice of treatment also affects recovery. For example, you may need to wear a splint for 6 weeks. But most patients with trigger finger recover within a few weeks by resting the finger and using anti-inflammatory drugs.
You should be able to move your finger just after surgery. Raising your hand above your heart can ease swelling and pain. Full recovery may take a few weeks, but swelling and stiffness may linger for 6 months. If your finger was super stiff before surgery, the doctor will probably suggest physical therapy to teach you exercises to help loosen it.