What Is Trigger Finger?
Trigger finger is a painful condition that makes your fingers or thumb catch or lock when you bend them. It can affect any finger or more than one finger at a time. You can also have it in both hands. You might hear it called stenosing tenosynovitis. When it affects your thumb, it’s called trigger thumb.
Trigger Finger Symptoms
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 mild and get worse over time. It’s more likely to happen after a period of heavy hand use than after an injury. It’s often worse:
- In the morning
- When you grasp something firmly
- When you try to straighten your finger
Causes of Trigger Finger
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 membrane that surrounds joints and keeps them lubricated. Sometimes, a tendon gets inflamed and swollen. Long-term 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.
Trigger Finger Risk Factors
Things that make you more likely to have trigger finger include:
- Age. It usually shows up between ages 40 and 60.
- Sex. It’s more common in women than men.
- Health conditions. Diabetes, gout, and rheumatoid arthritis can lead to trigger finger.
- Job. It’s common among farmers, industrial workers, musicians, and anyone else who repeats finger and thumb movements.
- Surgery for carpal tunnel syndrome. It’s most common in the first 6 months after your operation.
Trigger Finger Diagnosis
There are no X-rays or lab tests to diagnose trigger finger. Your doctor will do a physical exam of your hand and fingers, and they’ll ask about your symptoms.
Trigger Finger Treatment
Treatment 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.
- Splints. Your doctor can give you one designed to keep your finger still.
- Stretching exercises. These gentle moves may ease stiffness and improve range of motion.
- NSAIDs. Your doctor may suggest over-the-counter drugs that fight inflammation, like ibuprofen or naproxen.
- Steroid injections. They might give you a steroid shot into the tendon sheath. It can keep your symptoms at bay for a year or more, but you could need two shots to get results.
If you have severe symptoms or if other treatments don’t work, your doctor may suggest surgery. There are two types:
- Percutaneous release. The doctor numbs the palm of your hand and inserts a needle into the area around the affected tendon. They move the needle and your finger to loosen the tendon and make it work smoothly. This usually happens in the doctor’s office. They might use ultrasound to see where the tip of the needle is. This will help make sure they don’t damage your tendon or nearby nerves.
- Tenolysis or trigger finger release surgery. The doctor makes a small cut at the base of the finger and opens the sheath around the tendon. This usually happens in an operating room.
The time it takes to get better depends on your condition. 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 very stiff before surgery, your doctor will probably suggest physical therapy to teach you exercises to help loosen it.
Complications of trigger finger surgery
Any surgical procedure has some risks. Surgery for trigger finger may lead to complications like:
- Finger stiffness or pain
- Scarring and tenderness
- Nerve damage
- Tendon in the wrong position (bowstringing)
- Pain and swelling in your hand (complex regional pain syndrome or CRPS). This usually goes away over a few months.