Trigger finger occurs when bending or straightening a finger becomes stiff, painful, or feels unexpectedly difficult. The affected finger may also lock or catch when bent and then snap straight when released. Mild cases often resolve with rest or activity modification; however, patients with persistent or worsening symptoms may benefit from seeing an orthopaedic hand specialist who can identify the cause and recommend treatment options.

What is a trigger finger?

Trigger finger (stenosing tenosynovitis) is a condition that causes discomfort and a catching sensation when bending or straightening the fingers. During these movements, the tendon slides through a tunnel known as the tendon sheath. When inflamed or irritated, the tendon sheath can thicken or narrow.

This friction can cause the finger to catch or click during bending and straightening. A small lump may also form on the tendon. Any finger can develop trigger finger symptoms; however, the ring, middle, and thumb fingers are most commonly affected. One finger is typically affected; however, some people experience symptoms in multiple fingers simultaneously.

Symptoms of trigger finger 

Symptoms can start gradually, leaving the base of the finger tender or sore to the touch near the palm. Some patients notice increased stiffness after waking up or after extended periods without using the affected hand.

Clicking, popping, or catching of the finger can occur when bending or straightening your finger. Your finger may catch and then pop straight when bent. Some people experience locking of the finger, where it will not straighten.

In severe cases, people are unable to straighten the affected finger without assistance from the other hand. Some people experience increased pain when gripping objects, carrying bags, writing, or doing repeated hand movements. Pain can range from a mild annoyance to debilitating, affecting daily tasks.

 Causes of trigger finger

Repeated gripping and frequent use of the hands can lead to irritation of the tendons, which can cause symptoms. However, it has also occurred in people with no known cause.

Certain conditions such as diabetes or rheumatoid arthritis can increase the risk of developing the condition. Adults are more likely to experience it than children, and symptoms are most common in middle-aged and older people.

Jobs or hobbies that require repetitive gripping, grasping, squeezing or frequent use of hand tools may cause more stress on the tendons of your fingers. However, just because you participate in one of these activities does not mean you will develop a trigger finger.

Getting a diagnosis

A doctor will diagnose trigger finger after listening to your symptoms and performing a physical examination. They will ask you to open and close your hand and will check your fingers for tenderness, swelling, clicking, and/or locking.

During the physical examination, they will feel along the tendon at the base of your finger to check for swelling or a small lump. They can typically diagnose the condition without ordering any imaging tests. X-rays do not show swelling or inflammation of soft tissues and are typically not needed to diagnose it.

Treatment options

Treatment will vary depending on the severity of your symptoms and how long you have experienced them. For patients with mild symptoms that have not been present for long, resting the affected finger and avoiding repetitive-motion activities can help provide relief.

It may be recommended to wear a splint to keep your affected finger straight, or anti-inflammatory pain medication may be suggested. If rest and activity modifications do not provide relief after a few weeks, a corticosteroid injection may be administered into the tendon sheath.

The injection contains a medicine that helps decrease pain and swelling. Surgery is typically only recommended if other nonsurgical treatments fail to provide relief. Trigger finger release surgery involves cutting open the portion of the tendon sheath that is swollen to reduce pressure on the tendon. It is performed through a small incision at the base of your affected finger. Recovery is typically quick and can be undergone on an outpatient basis.

When to see a hand orthopaedic specialist

If you experience symptoms for several weeks, notice a decline in your ability to perform daily tasks or work-related functions, or if your symptoms worsen, it may be time to seek medical treatment. Some patients ignore the pain until they can no longer straighten the affected finger.

Seeing a hand specialist early can help reduce long-term stiffness and may allow for nonsurgical treatment options. If your finger locks and you are unable to straighten it, seek medical attention.

Whether you enjoy typing, cooking, or gripping tools and sporting equipment, trigger finger can make these activities difficult. Mild cases may improve with rest or by avoiding activities that irritate. If your finger repeatedly catches, is painful to move, or locks, you should make an appointment with a doctor. If you aren’t sure who to consult, search online for a 'hand surgeon near me' to find a qualified specialist. They can determine how severe your condition is and whether nonsurgical or surgical treatment is the best option. Prompt treatment can allow you to return to comfortable hand movements.