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.
Trigger Finger Symptoms
You might notice:
- A painful clicking or snapping sensation 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
Can you get trigger finger in your thumb?
Yes. When your thumb is affected, that's called trigger thumb.
Causes of Trigger Finger
Repeated movement or forceful use of your finger or thumb can lead to inflammation of a tendon, which can cause trigger finger.
You also might get trigger finger from something called contact friction, the result of holding something that vibrates. Using power tools is a common cause of contact friction, but even something like gripping bicycle handlebars can set it off.
To understand trigger finger, you need to understand the anatomy of your hand. Tendons are strong cords that connect muscles and bone. When you contract a muscle, your tendon pulls on the attached bone to make it move. Tendons are very strong, but they aren't especially stretchy. They can be injured easily from too much strain, and they can take a long time to heal.
Tendons are surrounded by a tissue layer known as the synovial sheath, which allows tendons to slide easily. Surrounding both the tendon and the sheath are soft tissue structures called pulleys. When your finger is working correctly, the tendon and sheath slide easily through the pulleys. Sometimes, a tendon or the surrounding synovial sheath 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 in men.
- Health conditions. Diabetes, gout, rheumatoid arthritis, osteoarthritis, thyroid conditions, and tuberculosis can lead to trigger finger.
- Job. It’s common among farmers, industrial workers, musicians, and anyone else who repeats finger and thumb movements.
- Hobbies. People who play racket sports such as tennis or pickleball are at risk.
- 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.
- Hot and cold treatment. Go back and forth between icing the area and applying heat.
- Trigger finger splints. Your doctor can give you one designed to keep your finger still.
- Stretching exercises. These gentle moves may ease stiffness and improve the range of motion.
- NSAIDs. Your doctor may suggest over-the-counter drugs that fight inflammation, such as ibuprofen or naproxen. You may be able to use creams or patches that apply the drug right to your finger.
- 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.
Trigger Finger Release
Trigger finger release is surgery that makes it easier to bend and straighten your finger. If you have severe symptoms or if other treatments don’t work, your doctor may suggest it. 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.
Surgery recovery
The time it takes to get better after surgery 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
Every surgical procedure has some risks. Surgery for trigger finger may lead to complications such as:
- Infection
- 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 after a few months.
Trigger Finger Exercises
Exercise can help with trigger finger symptoms. Start with this routine 3-5 times a day and gradually increase your workout. Aim for one session every hour.
Passive wrist stretch
Hold your palms together just below your chin. Lower your hands slowly toward your waist, keeping your hands close to your body and your palms together. You'll feel the stretch in your wrist and fingers. Hold for 10 seconds.
Fingertip bend
Hold your finger just below the tip. Bend the tip, but keep the rest of the finger straight. Repeat 3-5 times.
Bend fingertip and middle joint
Hold the big knuckle (the one in your hand) straight while bending the tip and middle joint of your finger. Repeat 3-5 times.
Trigger Finger Prevention
You can help avoid trigger finger by taking these steps:
- Make sure you're using the right technique for sports and handling tools
- Start a new activity or exercise slowly
- If you're doing a task that puts a lot of strain on your hands, take frequent breaks
- Wear padded gloves if you must use machinery that vibrates in your hand
Takeaways
Trigger finger is a condition that makes bending and straightening your finger difficult. The ring finger is most commonly affected, but you can get it in your thumb, too. You'll have the sensation of your finger locking or catching. That's because the tendon isn't moving freely. Rest, splints, exercises, and medicine can help. If your condition doesn't improve, your doctor might suggest surgery.
Trigger Finger FAQs
What's the most common cause of trigger finger?
Certain health conditions make you more likely to get it, but trigger finger is usually caused by overwork or strain. The most common causes are jobs or hobbies that involve repetitive movements such as gripping, lifting, and squeezing.
What happens if trigger finger isn't treated?
Untreated trigger finger makes it hard to type, button your shirt, or unlock a door. You may have trouble holding tools or gripping the steering wheel of your car. It generally won't heal on its own.
What can be done for trigger finger?
You may be able to treat your trigger finger with ice and heat, rest, splints, or anti-inflammatory medicines. If those options don't work, your doctor might recommend surgery.