Caring & Treating Since 2005
‘Ouch! My Finger!’
What is trigger finger?
Trigger finger, also known as stenosing tenosynovitis, is a painful condition which causes catching or locking when bending or straightening the finger.
Usually, the ring finger or thumb is affected. It can affect one or more fingers, and both hands can be involved.
Cause of Trigger Finger
Anatomy & Cause
The flexor tendons are long cord-like structures that attach the forearm muscles to the bones of the fingers. These flexor tendons allow the fingers to bend when the muscles contract. The flexor tendons pass through the palm and fingers via a tunnel known as the tendon sheath and allow them to glide smoothly as the fingers bend and straighten.
Along the tendon sheath, there are bands of fibrous tissue called pulleys, which hold the flexor tendons closely to the finger bones. The tendons pass through the pulleys as the finger moves. The pulley at the base of the finger is called the A1 pulley.
Trigger finger occurs when the A1 pulley of the affected finger becomes inflamed or thickened, which can interfere with the normal gliding motion of the tendon through the sheath. Prolonged irritation over time leads to inflammation of the flexor tendon itself and the formation of a nodule. When the finger flexes and the nodule passes through the pulley, there is a sensation of catching or popping.
Signs and Symptoms
What are the Signs and Symptoms of Trigger Finger?
- A popping or clicking sensation along with finger movement
- Finger locking or catching when straightening from a bent position, which then suddenly snaps straight, often with pain
- Finger stiffness, worse in the morning or after a period of inactivity
- Pain or swelling in the palm near the base of the affected finger
- In severe cases, the finger may remain locked in a bent position and is unable to straighten
What are the Risk Factor of Trigger Finger?
The factors that may lead to an increased risk of trigger finger include:
- Tends to occur between ages 40-60
- More common in women than men
- Tends to affect people whose job or hobby includes repetitive hand movements or gripping, such as technicians, industrial workers, musicians or athletes
Pre-existing medical conditionssuch as diabetes and rheumatoid arthritis
How do I Know if I have Trigger Finger?
Trigger finger can be diagnosed by your doctor after a detailed history and physical examination of the hand and affected finger.
Usually, no investigations or X-rays are required.
What are the Treatment available for Trigger Finger?
The treatment for trigger finger depends on the severity and include:
- Avoidance of the causative activity, or using of padded gloves
- Painkillers such as paracetamol and nonsteroidal anti-inflammatory drugs (NSAIDs)
- Gentle stretching exercises to reduce stiffness and improve mobility of the finger
- Wearing a splint at night to keep the finger in an extended position, for up to six weeks
- Corticosteroid (H&L) injection. This is injected into and around the tendon sheath and reduces the inflammation. The effect may be temporary, usually around 3 months, but may sometimes last a year or longer. More than one injection may be necessary.
- If all else fails, surgery can be considered. The procedure is known as a trigger finger release and is performed under local anaesthesia.