Trigger Finger Treatment
When the tendon that bends a finger catches in its sheath, the finger clicks and locks. It is treated with an injection or a small release operation.
Trigger finger (stenosing tenosynovitis) is when the tendon that bends a finger catches at the entrance to its sheath in the palm (the A1 pulley). When the tendon or pulley thickens, the tendon cannot glide freely; the finger catches as it bends and straightens, locks, and then snaps open like a trigger. It most often affects the thumb, middle and ring fingers.
Who gets it?
- Adults aged 40-60, especially women
- People with diabetes
- People with rheumatoid arthritis and thyroid disease
- Those whose work involves repeated, forceful gripping
- People with carpal tunnel syndrome
Symptoms
- Pain and tenderness in the palm at the base of the finger
- A clicking or catching feeling when moving the finger
- Locking, especially in the morning
- Having to straighten the locked finger with the other hand
- In later stages, the finger stuck bent or straight
Diagnosis
The diagnosis is made on examination. A tender nodule may be felt at the base of the finger and catching can be felt as the finger moves. Further tests are usually not needed.
Treatment
Non-surgical treatment
- Short rest and fewer straining movements
- A finger splint, especially at night
- Steroid injection: An injection into the tendon sheath relieves symptoms in many patients. In people with diabetes the effect may be more limited and blood sugar may rise temporarily.
Surgery: trigger finger release
Surgery is used when symptoms continue despite injection, keep recurring or the finger stays locked. Under local anaesthesia, the A1 pulley is released through a small incision in the palm so the tendon can glide freely. It takes a short time and the patient goes home the same day. Percutaneous release with a needle can be done in selected patients.
Recovery
- The finger is moved straight after surgery.
- Stitches are removed after about 10-14 days.
- Light daily tasks can be resumed within a few days.
- Tenderness in the palm eases over a few weeks.
Stages of trigger finger
Trigger finger usually progresses in stages. At first there is only pain and tenderness at the base of the finger. Then the finger starts to catch and click when moving but can still straighten on its own. Later, the other hand is needed to straighten the locked finger. In the most advanced stage, the finger is stuck bent or straight and cannot be moved. Treatment is chosen according to the stage; non-surgical methods have a better chance of success early on.
Trigger thumb in children
In babies and young children, a trigger thumb, where the tip joint of the thumb stays bent, is different from adult trigger finger. It is usually painless and often noticed by chance. Some cases improve on their own. Those that do not are treated with a small operation at a suitable age.
Diabetes and trigger finger
Trigger finger is more common in people with diabetes, can affect several fingers and may respond less well to injections. Because blood sugar can rise for a few days after a steroid injection, people with diabetes are advised to check their blood sugar more often during that time.
Exercises after surgery
Full bending and straightening exercises start straight after surgery to prevent stiffness in the finger joints. In fingers that have been locked for a long time, a slight bend may remain at the middle joint; hand therapy and a night splint can help.
Frequently asked questions
Does trigger finger go away on its own?
Mild cases can improve with rest, but most patients need an injection or surgery.
How many steroid injections can I have?
A limited number of injections is usually recommended. If symptoms keep returning, surgery offers a more lasting solution.
Can it come back after surgery?
Recurrence in the same finger after a proper release is rare, although trigger finger can develop in other fingers.
Can several fingers be treated at the same time?
Yes. If there are several trigger fingers in the same hand, they can be released in one session when appropriate.
When can I get my hand wet after surgery?
Keep the incision dry until it has healed and the stitches are removed, usually about two weeks.
Is trigger finger a sign of rheumatism?
Trigger finger is usually an isolated problem. If several fingers are affected along with joint swelling, an assessment for rheumatic disease may be done.
Is the steroid injection painful?
There is brief discomfort during the injection, and mild pain may follow for a day or two.
Does trigger finger count as a work injury?
Trigger finger usually develops from repeated strain and individual tendency. Official assessments follow the criteria of the relevant institutions.
The information on this page is general and does not replace an examination. An examination is needed to decide which treatment suits you.