Trigger finger is a painful condition that causes the fingers or thumb to
catch or lock when bent. In the thumb its called trigger thumb.
Trigger finger happens when tendons in the finger or thumb become inflamed.
Tendons are tough bands of tissue that connect muscles and bones. Together, the
tendons and muscles in the hands and arms bend and straighten the fingers and
A tendon usually glides easily through the tissue that covers it (called a
sheath) because of a lubricating membrane surrounding the joint called the
synovium. Sometimes a tendon may become inflamed and swollen. When this
happens, bending the finger or thumb can pull the inflamed tendon through a
narrowed tendon sheath, making it snap or pop.
What Causes Trigger Finger?
Trigger finger can be caused by a repeated movement or forceful use of the
finger or thumb. Rheumatoid arthritis, gout, and diabetes also can cause
trigger finger. So can grasping something, such as a power tool, with a firm
grip for a long time.
Who Gets Trigger Finger?
Farmers, industrial workers, and musicians often get trigger finger since
they repeat finger and thumb movements a lot. Even smokers can get trigger thumb
from repeated use of a lighter, for example. Trigger finger is more common in
women than men and tends to happen most often in people who are 40 to 60 years
What Are the Symptoms of Trigger Finger?
One of the first symptoms of trigger finger is soreness at the base of the
finger or thumb. The most common symptom is a painful clicking or snapping when
bending or straightening the finger. This catching sensation tends to get worse
after resting the finger or thumb and loosens up with movement.
In some cases, the finger or thumb locks in a bent or straight position as
the condition gets worse and must be gently straightened with the other hand.
How Is Trigger Finger Diagnosed?
Trigger finger is diagnosed with a physical exam of the hand and fingers. In
some cases, the finger may be swollen and there may be a bump over the joint in
the palm of the hand. The finger also may be locked in bent position, or it may
be stiff and painful. No X-rays or lab tests are used to diagnose trigger
How Is Trigger Finger Treated?
Most trigger digits in adults can be managed successfully with local steroid
injections and splinting. Oral or topical pharmacologic measures have not been
demonstrated to be effective.
The outcome of conservative treatment for pediatric trigger thumb is
somewhat controversial. A report by Baek et al on the natural history of this
condition demonstrated after a follow-up period of 5 years or more in patients
who received no treatment for pediatric trigger thumb, complete resolution of
flexion deformity occurred in 66 out of 87 thumbs (75.9%), and partial
improvement occurred in the remaining 21 thumbs.
Another study, by Lee et al, reported that extension splinting for 12 weeks
led to improvement in 71% of thumbs, compared with 23% improvement in patients
not receiving any treatment. See also the current recommendations described by
The chief indications for surgical management of trigger finger (TF) are as
splinting and/or injection treatment
thumb in infants (without surgical release, these infants are likely to
develop a fixed flexion deformity of the interphalangeal [IP] joint)
Although the results of percutaneous release are well established, the open
technique is absolutely essential for the thumb or little finger or in the
presence of proximal interphalangeal (PIP) contractures. Percutaneous release
should be reserved for the index, middle, and ring fingers.
In a study from Oxford comparing percutaneous and open surgical methods,
both procedures displayed similar effectiveness and proved superior to
conservative corticosteroid-injection treatment regarding trigger cure and
In children, triggering has varying causes. Release of the A1 pulley alone
does not always correct the problem. Additional treatment (eg, resection of 1
or both limbs of the flexor digitorum superficialis [FDS] tendon, A3 pulley
release) may be required and is recommended in rheumatoid arthritis (RA) tenosynovitis.
In infants, the nodule on the flexor pollicis longus (FPL) tendon can be
resected with good results. Corticosteroid injections are generally not helpful
in these cases of trigger thumb.
How Long Does Recovery From Trigger Finger Take?
The time it takes to recover from
trigger finger depends on how bad it is. The choice of treatment also affects
recovery. For example, splinting may be necessary for six weeks. But most
patients with trigger finger recover within a few weeks by resting the finger
and using anti-inflammatory drugs.