Trigger Finger

What is Trigger Finger?

Trigger finger, also known as stenosing tenosynovitis, is a locking or catching of the finger joint due to limited mobility of the tendons responsible for opening and closing the finger.  The finger becomes difficult to extend, may pop or snap upon extension, or may become completely locked in a bent position.

What causes Trigger Finger?

A trigger finger is caused by a narrowing of the passageway that houses the tendons that control movement of the finger.  The tendons become irritated as they move through the passageway and can thicken as a result of the irritation.  As the passageway becomes smaller due to the thickening tendons, they may get stuck momentarily at the edge of the passageway as the finger is extended, causing the finger to catch or feel stuck.  It is unknown why this irritation occurs, but individuals with certain medical conditions are more likely to have a trigger finger, such as those with rheumatoid arthritis or diabetes.  Women are also more likely to develop the condition.  Individuals that engage in activities that require repetitive gripping have a greater chance of developing trigger finger.

What are the symptoms of Trigger Finger?

Symptoms of trigger finger include a sensation of stiffness, locking, catching or popping when the finger is extended.  In some cases, the finger will catch but will then suddenly pop straight open.  In severe cases, the finger cannot be extended at all, even if manually manipulated.  Individuals may also notice a small lump and swelling by the base of the finger, as well as pain felt in the palm and base of the finger.  Trigger finger usually occurs on only one finger, but can affect multiple fingers.  Stiffness and other symptoms are usually worse with inactivity and ease up as the finger continues to move.  

How is Trigger Finger diagnosed?

A medical professional will perform a physical exam and will ask questions related to the type and severity of symptoms, when they began, and what makes them better or worse.  Diagnosis can easily be made based on a description of symptoms and a physical exam.  No diagnostic tests are needed.

When should I seek care for Trigger Finger?

If you feel pain and stiffness in your finger that increases over time, a popping sensation when the finger is extended, or your finger becomes locked and cannot be straightened, you should seek medical advice.  If the pain and stiffness is accompanied by redness and warmth, you may have an infection and should seek immediate medical attention.  If your symptoms are caused by a traumatic injury to your finger, you should also seek medical attention to determine if you have a bone fracture.

What will the treatment for Trigger Finger consist of?

Treatment for trigger finger may involve resting or splinting the finger in order to allow the inflammation to subside and the joint to heal, reducing symptoms.  Massaging the finger may relieve pain and stiffness and soaking the hand in warm water may provide some relief of symptoms.  Physical therapy, including exercises to increase finger mobility, may be recommended. Corticosteroid injections can provide relief but may require more than one injection to be successful.  Injections are less likely to be effective if the patient has had the condition for a long time.  If symptoms are severe, a procedure called a percutaneous trigger finger release may be performed to release the locked finger.  Surgery is a last resort option and involves widening the tunnel in which the tendons travel from the palm into the finger so that they can move more easily and will not get stuck.  

Which muscle groups/joints are commonly affected by Trigger Finger?

Trigger finger affects the ligaments that travel from the palm into the fingers and thumb, affecting mobility of the fingers and thumb.

What type of results should I expect from the treatment of Trigger Finger?

Mild cases of trigger finger should improve within 4 – 6 weeks with a period of rest and splinting to reduce inflammation of the tendons and surrounding sheath.  The main goal of treatment is to reduce inflammation, so any activities that contribute to symptoms (such as repetitive gripping) should be avoided in order for recovery to occur and a recurrence to be avoided.  Corticosteroid injections are effective in some cases, but a patient may need multiple injections to experience relief of symptoms.  A percutaneous trigger finger release procedure or surgery is typically successful in relieving any problems associated with trigger finger and can provide almost instant relief.  Physical therapy is often required to improve flexibility in the fingers and hand following these procedures.