Trigger Finger

Trigger finger, also called stenosing tenosynovitis, is a condition where one of the fingers (or thumb) remains stuck in a bent position for periods of time. This condition occurs when inflammation narrows the space between the tendon and the sheath surrounding it in the finger.

With trigger finger, the tendon in the finger becomes swollen and inflamed and can no longer easily slide through the sheath. A bump, or nodule, may also form on the tendon, which causes even more friction, preventing the tendon from moving smoothly through the sheath. This can cause a snapping or clicking sensation and sound when the finger is extended and bent. In severe cases, the finger will be unable to extend from a bent position.

Trigger finger occurs when the tendon of the affected finger becomes inflamed and irritated. Repeated use of the fingers and thumb can be a risk factor. Farmers, musicians and industrial workers, who use their hands repeatedly, can being more susceptible to the condition. However, there are many factors that can contribute to trigger finger, including:

• Repeated gripping or other use of fingers and thumb
• Diabetes
• Rheumatoid arthritis
• Complications of carpal tunnel syndrome surgery

Trigger finger can affect any finger, as well as the thumb. Multiple fingers may be affected at a time on either hand. Trigger finger is often the most pronounced in the morning after sleeping. The symptoms associated with trigger finger can progress rapidly from mild to severe. The symptoms of trigger finger include:

• Finger stiffness
• A popping or snapping sensation when bending or extending the finger
• Tenderness
• A bump in the palm at the base of the affected finger
• Bent finger suddenly popping straight and extending
• Finger locking in a bent position and the inability to straighten the finger

Your doctor will diagnose trigger finger by examining your hand and discussing your symptoms with you. You will be asked to open and close your hand. This allows the physician to look for tenderness, thickening or swelling of the tendon sheath; a lump at the base of your finger; and/or “triggering” — or catching — when you bend and straighten your finger. Most times, x-rays or other imaging tests are not required for the diagnosis.

There are various non-invasive treatments for trigger finger, but if symptoms persist, surgery can be recommended.

Non-Surgical Treatments

For mild cases of trigger finger, resting and avoiding activities that aggravate the condition can help alleviate symptoms. Sometimes a splint may be used to immobilize the affected joint. Anti-inflammatory medications, such as NSAIDs, may also be prescribed. Your doctor may also consider a steroid injection, depending on the severity of symptoms.

Surgical Treatments

If non-invasive treatments are ineffective, a procedure called a percutaneous release can be used to treat trigger finger. The palm is numbed, and a needle is inserted into the tissue around the affected tendon using ultrasound imaging. The doctor uses the needle to break apart the constriction affecting the tendon’s movement.

Surgery is also an option for trigger finger. Done under local anesthesia, the doctor makes a small cut in the finger sheath where the tendons pass through. This helps widen the space around the tendons, allowing them to slide more easily through the sheath. The surgery helps restore the affected finger’s ability to bend and straighten without pain or stiffness.