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Trigger finger

Trigger finger (stenosing tenosynovitis) is a condition where your finger or thumb clicks, or gets locked in place, when you make a fist.

Trigger finger happens when part of the tendon in your finger becomes inflamed and swollen. Tendons are long cords that run along the length of each of your fingers, connecting your finger bones to the muscles in your forearms. They allow you to move your fingers. Your tendons are kept in place by strong bands of tissue, called ligaments, which form a tube called a tendon sheath. Your tendons should move smoothly in and out of the tendon sheaths as you bend and straighten your fingers.

If one of your tendons becomes inflamed, it may catch on the opening of the tendon sheath at the base of your finger. This catching can cause a clicking sensation and your finger can sometimes gets stuck (locked) in a bent position.

Around three in 100 people are affected by trigger finger. It most often affects your thumb (trigger thumb) followed by your ring, long, little and index fingers. Several of your fingers can be affected at one time.

Trigger finger is more common in women than men. People of any age can get it (including children) but most people who get trigger finger are between 50 and 60.

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An image showing a hand with trigger finger

Details

  • Symptoms Symptoms of trigger finger

    Symptoms of trigger finger include:

    • a clicking sensation when you try to move your finger
    • your finger getting stuck (locked) in a bent position – you will probably need to pull it straight with your other hand
    • pain in your palm
    • tenderness and pain in your finger, particularly when you grip
    • stiffness in your finger, which may be worse first thing in the morning
  • Diagnosis Diagnosis of trigger finger

    Your GP will ask about your symptoms and examine you. He or she may also ask you about your medical history.

    Your GP will feel the affected finger to see if there is tenderness or a nodule in your palm at the base of the finger. Your GP may ask you to bend and straighten your fingers. He or she will then feel the palm of your hand, as this is where the catching of the tendon happens.

    If your GP is unable to diagnose trigger finger by examining you, he or she may refer you to have an ultrasound scan.

    If your GP suspects that you have trigger finger, he or she may refer you to a specialist hand surgeon for treatment.

  • Treatment Treatment of trigger finger

    Mild trigger finger may get better without any treatment. If the problem doesn't go away after a few weeks, you may want to consider treatment. There are a number of treatment options if your trigger finger does persist.

    Self-help

    If possible, try not to do any activities that cause you pain.

    Medicines

    Anti-inflammatory drugs, such as ibuprofen may help to reduce pain and swelling in your finger. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.

    Your GP or hand specialist may inject a medicine called a steroid (often a corticosteroid) into the inflamed area of your tendon. This will reduce the inflammation, so your symptoms should improve. You may see an improvement a few days after the injection, but it can take up to a few weeks before you notice any difference. The site of the injection may feel tender afterwards. If one injection doesn't help, you may need to have a second injection.

    Steroid injections are effective in up to nine in 10 people. However, they are less successful if you have diabetes or rheumatoid arthritis. If there is no improvement in your symptoms after having steroid injections, you may need a small operation to treat trigger finger.

    Non-surgical treatment

    If your trigger finger is mild, you may be able to treat it with a splint. Your hand specialist can fit a splint and you can then put it on your finger at night to keep it straight. If the splint hasn't helped after wearing it for six weeks, you may need to try another treatment.

    Surgery

    You will usually only need to have trigger finger release surgery if all other types of treatment haven't worked. You may also need to have surgery if your finger is permanently locked, or if another condition, such as diabetes, is causing your trigger finger. Surgery is very effective and is usually a permanent solution to the problem.

    Percutaneous trigger finger release

    It may be possible to release your tendon from the sheath using a needle. This is called percutaneous trigger finger release. It's done under a local anaesthetic, which completely blocks pain from the area and you will stay awake during the procedure. Percutaneous trigger finger release isn't a suitable treatment for everyone. Ask your doctor if it’s suitable for you.

    Open surgery

    If you have open surgery, you will usually have local anaesthesia before the operation. Sometimes a regional or a general anaesthesia is used instead. A regional anaesthetic will block pain from your entire arm. If you have a general anaesthetic, you will be asleep during the procedure.

    Your surgeon will then make a small cut into the palm of your hand. He or she will release the ligament that is catching on the tendon. Your surgeon will close the wound using stitches and cover it with a small dressing. You will need to keep the dressing in place for a week or two after the operation.

  • Muscle, bone and joint treatment

    At our Bupa Health Centres, we offer self-pay health services for a wide range of conditions, including muscle, bone and joint treatment.

  • Causes Causes of trigger finger

    The exact reasons why you may develop trigger finger aren't fully understood at present. However, it's thought to be caused by inflammation of part of the tendon in your finger. In most people there is no clear cause of this inflammation but it can sometimes be aggravated by activities that strain your hand. For example, if you regularly use heavy gardening shears. Rarely, trigger finger can be caused by an injury to your hand.

    Trigger finger is more common in people with certain health conditions, including:

    • diabetes
    • carpal tunnel syndrome
    • inflammatory conditions, such as rheumatoid arthritis – an inflammatory condition that can cause you to develop nodules (bumps) in your tendons
    • an underactive thyroid gland (hypothyroidism)
    • amyloidosis – a group of diseases in which deposits of abnormal proteins (known as amyloid) build up in one or more of your organs
  • FAQs FAQs

    Are trigger finger and carpal tunnel syndrome related?

    Answer

    No, trigger finger and carpal tunnel syndrome are two separate conditions. However, it's possible that you could have both trigger finger and carpal tunnel syndrome at the same time.

    Explanation

    Carpal tunnel syndrome and trigger finger are both disorders of your hand and wrist.

    Carpal tunnel syndrome causes pain, numbness and tingling in your hand and forearm and is caused by pressure on a nerve in your wrist. Trigger finger is a condition where a tendon in your finger becomes inflamed and catches against the sheath that surrounds it. This can cause your finger to make a clicking sound as you bend it, or it may become locked in a bent position. Trigger finger can happen at the same time as other disorders of your hand and wrist, such as carpal tunnel syndrome.

    If you have any symptoms of carpal tunnel syndrome or trigger finger, see your GP for advice.

    Can trigger finger occur in children?

    Answer

    Yes, trigger finger can affect children but it's more common in adults.

    Explanation

    Children can get trigger finger and trigger thumb, but trigger thumb is more common. This usually happens between the ages of six months and two years. Children rarely get any pain from trigger thumb.

    For most children (six out of 10 children), trigger thumb gets better without having any treatment. In others, a splint may help, which is used to keep their thumb straight. Sometimes surgery is used to treat trigger thumb.

    If I have trigger finger, will I develop arthritis?

    Answer

    No, there is no association between trigger finger and developing arthritis.

    Explanation

    Trigger finger doesn't cause arthritis, but it does happen more often in people who have rheumatoid arthritis.

    Arthritis is inflammation of your joints. Rheumatoid arthritis is an autoimmune disease, which means that your body's immune system starts to attack your body tissues, causing inflammation. Rheumatoid arthritis can cause inflammation of your tendons as well as your joints, meaning that you’re more likely to get trigger finger.

  • Resources Resources

    Further information

    • British Society for Surgery of the Hand
      020 7831 5162
      www.bssh.ac.uk

    Sources

    • Trigger finger. Map of Medicine. www.mapofmedicine.com, published 5 April 2013
    • Trigger finger. American Society for Surgery of the Hand. www.assh.org, published 2012
    • Trigger finger. American Academy of Orthopaedic Surgeons. www.orthoinfo.aaos.org, published June 2010
    • Trigger finger. Medscape. www.emedicine.medscape.com, published 22 May 2012
    • Ventin FC, Lenza M, Tamaoki MJS, et al. Surgery for trigger finger (protocol). Cochrane Database of Systematic Reviews 2012, Issue 6. doi: 10.1002/14651858.CD009860.
    • BSSH evidence for surgical treatment: trigger finger (thumb). The British Society for Surgery of the Hand. www.bssh.ac.uk, published 1 August 2013
    • Trigger finger/thumb. The British Society for Surgery of the Hand. www.bssh.ac.uk, published 5 February 2012
    • Rheumatoid arthritis. Medscape. www.emedicine.medscape.com, published 30 July 2013
    • What is carpal tunnel syndrome? Arthritis Research UK. www.arthritisresearchuk.org, accessed 2 August 2013
    • What are the symptoms of carpal tunnel syndrome? Arthritis Research UK. www.arthritisresearchuk.org, accessed 2 August 2013
    • Trigger thumb. Medscape. www.emedicine.medscape.com, published 10 February 2012
  • Related information Related information

  • Author information Author information

    Reviewed by Rachael Mayfield-Blake, Bupa Health Information Team, September 2013.

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