Trigger finger

August 20, 2023

What is Trigger Finger?

Do you have a finger (digit) that feels stiff and sore when you straighten (extend) it after it has been bent (flexed)? Have you heard of the term trigger finger? Trigger finger is a condition affecting one or more of the tendons (flexor tendon) that flex fingers or thumb. It is a sensation of locking, catching, or clicking when you bend and straighten your fingers. You may or may not experience pain and stiffness in the fingers or thumb. You may need to physically extend the digit using the other hand.

If a tendon or the tunnel (tendon sheath) the tendons runs through becomes swollen or inflamed, the tendon gets irritated and thickened and can catch in the tendon sheath. This can make it difficult to bend and straighten the affected finger or thumb. Trigger finger is also known as stenosing flexor tenosynovitis.

What are the symptoms?

• Clicking/locking of the finger during movement. Often worse in the mornings. The finger might need to be straightened with pressure from the opposite hand.
• Pain at the site of the triggering in the palm. Mild pain with a small lump can be felt when pressing on the triggered area.
• Stiffness, especially in trigger thumb where movement at the end joint is reduced.

Causes of trigger finger:

Tendons are string like tissue that attaches a muscle to a bone. In this case the tendon comes from a muscle in the forearm. It passes through the palm and attaches to the digit bone. The tendon sheath is like a tunnel that covers and protects part of the tendon. Normally the tendon slides easily in and out of the sheath as you bend and straighten the finger.

The exact cause is often not clear, but in trigger finger the tendon can slide through the sheath as you bend your finger but cannot easily slide back in due to swelling from inflammation.

Several factors may increase the likelihood of trigger finger developing. For example:

• It is more common in women
• People over 40 years old
• It is more likely if you had previous injuries to your palm or finger
• Long-term conditions such as diabetes and rheumatoid arthritis

Treatment and management for trigger fingers:

In around one in five people symptoms improve without treatment. You might need to rest your hand and try not to do any activities that make it worse for a while. If the trigger finger does not improve with a period of rest then you may require one of the following:

• Splinting – the affected finger is strapped to a plastic splint so that it is completely straight.
• Pain relieving medication – non-steroid anti-inflammatory drugs (NSAIDs) may help to reduce your pain. Consult your GP to discuss which medication is best for you to take.
• Steroid injection – a steroid injection into the tendon sheath is a form of treatment if the condition does not settle. Steroid injections are an effective treatment for trigger finger, working by reducing inflammation. See the link below for more information about steroid injections and what we offer at Physiotherapy Matters.
• Surgery – an operation done under local anesthetic might be the next treatment option if the above options has been unsuccessful. A small cut is made at the base of the finger and the tendon sheath is widened. Surgical treatment is usually used as a last options but are highly successful.