Trigger finger happens when part of the tendon in your finger or the tube it runs through (tendon sheath) 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. Your tendons should move smoothly within the tendon sheaths as you bend and straighten your fingers.
If you have trigger finger, the tendon sheath thickens and so the tendon can’t run through smoothly. The fibres of your tendon may ‘bunch up’ to form a nodule. This then catches on the opening of the sheath at the base of your finger or thumb. This catching can cause a clicking or popping sensation when you move your finger. Your finger can sometimes get stuck (locked) in a bent position.
Symptoms of trigger finger include:
- a catching or popping sensation when you bend and straighten your finger
- your finger getting stuck (locked) in a bent position – you’ll probably need to pull it straight with your other hand
- pain in your palm, especially at the base of the affected finger
- stiffness in your finger, which may be worse first thing in the morning
You may also notice early signs of trigger finger in your other fingers, on one or both hands.
Your GP will ask about your symptoms and examine your hand. They may also ask you about your medical history, what work you do and if you’ve been doing repetitive activities using your hands.
Your GP will feel the affected finger to see if there’s tenderness or a nodule in your palm at the base of the finger. They may ask you to bend and straighten your fingers while they feel the palm of your hand. This may let them feel the catching of your tendon. Tell your GP if your hand is painful so that they know to take extra care when examining it.
In most cases, no further tests are needed to diagnose trigger finger. But if your GP still isn’t sure if you have trigger finger after examining you, they may recommend you have an ultrasound scan.
Sometimes, trigger finger gets better without any treatment. Your doctor may advise you to rest your hand, and try not to do any activities that cause pain for a while. Some mild cases may be better in a few weeks, but often this may take over six months.
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. These include painkillers, splinting, steroid injections and surgery.
Splinting and pain relief
Your doctor may recommend that you try a combination of splinting and pain relief for four to six weeks to see if this helps. Your hand specialist can fit a splint for you to put on your finger at night to keep it straight. This means the roughened part of the affected tendon will be held still within its sheath while you sleep.
Over-the-counter anti-inflammatory drugs, such as ibuprofen may help to reduce pain and swelling in your finger temporarily. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.
As an alternative to splinting, or if splinting doesn’t help, your doctor may offer you a steroid injection. Your GP or hand specialist will inject a steroid medicine into the inflamed area of your tendon. The steroid may be mixed with a local anaesthetic medicine. 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. You may have some pain in your hand for one or two days after the injection. If one injection doesn't help, you may need to have a second injection.
Steroid injections work in up to seven in 10 people. However, they may be less successful if you have diabetes or rheumatoid arthritis.
If there’s no improvement in your symptoms after having steroid injections, you may need a small operation to treat trigger finger.
You’ll usually only need to have 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. Children with trigger thumb may need surgery. Surgery is usually a permanent solution to the problem.
There are two main types of surgery that your doctor may offer you. These are called ‘percutaneous trigger finger release’ and ‘open surgery’. See our topic on trigger finger release surgery for more information. Your doctor will discuss with you which option may be best in your own circumstances.
Trigger finger is caused by inflammation of the lining around the tendon. It’s often caused by intensive or repetitive manual activity, and things involving impact on the palm of your hand, like digging or pruning in the garden. But sometimes it’s not clear exactly what’s caused it.
Trigger finger is more common in women than men. People of any age can get it (including children) but it’s most likely to happen between the ages of 50 and 60.
Trigger finger is more common in people with certain health conditions, including:
- 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
You’re also more likely to get trigger finger if you have other problems in your hand and wrist such as Dupuytren’s contracture (Dupuytren’s disease) and carpal tunnel syndrome. See our frequently asked questions for more information.
FAQ: Carpal tunnel syndrome and Dupuytren’s contracture Are these conditions related to trigger finger?
Carpal tunnel syndrome causes pain, numbness and tingling in your hand and is caused by pressure on a nerve in your wrist. Trigger finger and carpal tunnel syndrome are two separate conditions but they can occur together. Doctors aren’t sure why, but it may be that they have a similar cause in some people.
Trigger finger may sometimes be confused with another condition affecting the hand called Dupuytren’s contracture (Dupuytren’s disease). Here the ligaments in your palm thicken and contract. Over time, this pulls one or more of your fingers into your palm. If you have this condition you may be more likely to get trigger finger too.
People who have diabetes are at an increased risk of all three of these conditions.
Yes, trigger finger can affect children but it's more common in adults. In children, it’s usually the thumb that’s affected. It’s most likely to be noticed between the ages of one and four. If your child has trigger thumb, you may notice that one or both of their thumbs is held bent. Trigger thumb isn’t usually painful in children.
For most children (up to six out of 10), trigger thumb gets better without having any treatment. In others, a splint which keeps their thumb straight may help. Surgery may be needed to treat trigger thumb if your child’s thumb is locked (stuck in a bent position). Ask your doctor what the options are for your child’s particular circumstances.
- British Society for Surgery of the Hand
- Tenosynovitis of the hand and wrist. BMJ Best practice. bestpractice.bmj.com, last updated 29 April 2016
- Trigger finger. Medscape. emedicine.medscape.com, updated 18 August 2015
- Map of Medicine. Trigger finger. International View. London: Map of Medicine; 2013 (Issue 2)
- Peters-Veluthamaningal C, van der Windt D, Winters J, et al. Corticosteroid injection for trigger finger in adults. Cochrane Database of Systematic Reviews 2009, Issue 1. doi:10.1002/14651858.CD005617.pub2
- Trigger finger/thumb. The British Society for Surgery of the Hand. www.bssh.ac.uk, accessed 17 May 2016
- Carpal tunnel syndrome. The British Society for Surgery of the Hand. www.bssh.ac.uk, accessed 17 May 2016
- Dupuytren's disease. The British Society for Surgery of the Hand. www.bssh.ac.uk, accessed 17 May 2016
- Trigger finger. American Academy of Orthopaedic Surgeons. www.orthoinfo.aaos.org, last reviewed June 2010
- Huisstede B, Hoogvliet P, Coert J, et al. Multidisciplinary consensus guideline for managing trigger finger: results from the European HANDGUIDE study. Phys Ther 2014; 94(10):1421–33. doi:10.2522/ptj.20130135
- Rottgers S, Lewis D, Wollstein RA. Concomitant presentation of carpal tunnel syndrome and trigger finger. J Brachial Plex Peripher Nerve Inj 2009; 4:13. doi:10.1186/1749-7221-4-13
- Related conditions. Diabetes UK. www.diabetes.org.uk, accessed 15 June 2016
- British Society for Surgery of the Hand
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Reviewed by Natalie Heaton, Specialist Health Editor, Bupa Health Content Team, June 2016.
Peer reviewed by Giles Bantick, Consultant Plastic Surgeon and Hand Surgeon.
Next review due June 2019.
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