What Is Trigger Finger?

Trigger finger is the common term for stenosing tenosynovitis, a medical condition which limits the grasping ability of one or more fingers. A person with this condition will find his or her finger locking up in a bent position, unable to be straightened out. The appearance of pulling an imaginary trigger is what gives the condition its name. The finger’s immobility is frequently accompanied by swelling and pain. Trigger finger can affect any of the hand’s digits but is most common in the ring finger and thumb. In the latter case, the condition is called trigger thumb.

Trigger finger is common, estimated to affect roughly two percent of the population. Though it curtails the use of the hand and is a source of worry, trigger finger is also relatively easy to diagnose and treat. For more information, see your Baptist Health medical provider or a member of our orthopedic team.

Causes & Risk Factors

All bodily movement occurs through the interaction of muscle and bone. Muscles and bones are connected throughout the body by tough, fibrous cords known as tendons. The muscles of your forearm, which enable movement in fingers, are attached to the bones of your hand by the flexor tendons. Each of these tendons is, in turn, enclosed in a flexor sheath. Your ability to flex and extend each of your fingers depends on the smooth movement of the tendon through its sheath.

Trigger finger occurs when this smooth movement is blocked by the inflammation of a reinforced point of the sheath, known as a pulley. The most common location is the A1 pulley at the finger’s base. Over time, this swelling extends to the flexor tendon itself, further restricting its movement. Attempts to force mobility become painful and are sometimes accompanied by a popping or catching sound. In severe cases, the finger locks up in a bent or trigger position.

Researchers are not entirely clear on the medical causes behind trigger finger, but several contributing factors have been identified:

• Physical activity: Certain types of job- or hobby-related physical activity appear to predispose a person to trigger finger. It occurs with above-average frequency among farmers, tool-and-die and other factory workers, musicians, and individuals who play racket sports such as tennis.
• Medical conditions: Trigger finger is correlated with a number of other medical conditions, including diabetes, gout, thyroid disease, and both rheumatoid and osteoarthritis.
• Age: Trigger finger occurs more frequently with advancing age, especially in persons 40 to 60 years old.

Another risk factor is sex. Women more commonly experience trigger finger than men.

Signs & Symptoms

Trigger finger tends to appear gradually rather than abruptly. Symptoms include:

• A lumpy or swollen area on the palm of the hand at the finger’s base
• A popping or catching sound when bending or unbending a digit
• Pain at the base of the finger
• The finger locking up in a flexed position

Though trigger finger shares symptoms with arthritis of the hand, it is a different type of condition. Trigger finger results from inflammation of the tendons; arthritis is a joint disease.

Diagnoses

Diagnosing trigger finger is typically a simple process. Your physician will:

• Ask you questions about your symptoms
• Conduct a physical exam of your wrists, hands, and fingers
• Inquire into possible causes or contributing factors, such as diabetes or arthritis

If the diagnosis remains in doubt, your physician may order an imaging test. An X-ray or ultrasound of your hand can provide visual evidence of your condition to supplement the physical exam.

Treatment for Trigger Finger

Treatment of trigger finger depends on its severity and extent. Options include:

• Changes in physical activity: Physical wear and tear can be one of the sources of tendon inflammation. Changes in routine, including breaks from activities that are hard on the hands, provide opportunities for stressed tissues to heal.
• Stretching exercises: A physician or physical therapist can assist you with exercises that reduce swelling in the hand and return your tendon to a normal position and shape.
• Splinting: A splint is a device for holding your fingers in an extended position, to counteract muscle contractions. It is often worn at night, when hand use is less, and stiffness is more likely to occur.
• Medications: Over-the-counter medications, such as aspirin, ibuprofen, and acetaminophen, can limit tendon pain and inflammation.
• Steroid injections: Your physician may opt to inject the A1 pulley of your trigger finger with cortisone, a high-powered anti-inflammatory drug. Cortisone shots can sometimes effect a cure.

Is There a Surgical Procedure for Trigger Finger?

In those cases where standard treatments fail, surgery may be required. Your physician will schedule a trigger finger release procedure. This is a minor operation performed on an outpatient basis. You will be given a local anesthetic. The surgeon makes an incision in the A1 pulley, dividing it to restore movement to the tendon. The loss of the A1 pulley should have no impact on your future health as long as the rest of the tendon sheath remains intact.

You will most likely return home the same day as your surgery. Begin moving your finger immediately. Some soreness is likely to occur. The complete recovery process can take from four to six months. Trigger finger release surgery has a documented track record for ending pain and restoring finger mobility, though range of motion may remain limited.

Prevention

If you think you may be at risk for trigger finger, there are preventive steps that you can take:

• Learn good technique: If your job or hobby involves repetitive hand motions, learn the best techniques for protecting hand health.
• Wear proper safety gear: Insulated gloves or mitts can shield your hands from a certain degree of wear and tear.
• Take breaks: Take regular breaks from tasks that increase hand strain.
• Start slow: If you begin a new physical activity or exercise, start slow and build your conditioning over time.

Learn More About Trigger Finger

Though trigger finger is rarely a serious medical threat, it can be, under more severe circumstances, a painful and limiting condition. If you are experiencing trigger finger symptoms, contact the Baptist Health Orthopedic team to schedule an appointment or complete your health assessment now.