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.
Symptoms of trigger finger include:
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:
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.
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.
If possible, try not to do any activities that cause you pain.
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.
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.
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.
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.
Reviewed by Rachael Mayfield-Blake, Bupa Health Information Team, September 2013.
For answers to frequently asked questions on this topic, see FAQs.
For sources and links to further information, see Resources.
This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.
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