Trigger finger, also known as stenosing tenosynovitis (stuh-NO-sing ten-o-sin-o-VIE-tis), is a condition in which one of your fingers gets stuck in a bent position. Your finger may straighten with a snap — like a trigger being pulled and released.
Trigger finger occurs when inflammation narrows the space within the sheath that surrounds the tendon in the affected finger. If trigger finger is severe, your finger may become locked in a bent position.
People whose work or hobbies require repetitive gripping actions are at higher risk of developing trigger finger. The condition is also more common in women and in anyone with diabetes. Treatment of trigger finger varies depending on the severity.
Signs and symptoms of trigger finger may progress from mild to severe and include:
- Finger stiffness, particularly in the morning
- A popping or clicking sensation as you move your finger
- Tenderness or a bump (nodule) in the palm at the base of the affected finger
- Finger catching or locking in a bent position, which suddenly pops straight
- Finger locked in a bent position, which you are unable to straighten
Trigger finger more commonly affects your thumb or your middle or ring finger. More than one finger may be affected at a time, and both hands might be involved. Triggering is usually more pronounced in the morning, while firmly grasping an object or when straightening your finger.
When to see a doctor
If you have any stiffness or catching in a finger joint, bring it to the attention of your doctor so that he or she may review your symptoms and perform a physical evaluation of your hand. If your finger joint is hot and inflamed, seek immediate medical care because these signs indicate a possible infection.
Tendons are fibrous cords that attach muscle to bone. Each tendon is surrounded by a protective sheath. Trigger finger occurs when the affected finger's tendon sheath becomes irritated and inflamed. This interferes with the normal gliding motion of the tendon through the sheath.
Prolonged irritation of the tendon sheath can produce scarring, thickening and the formation of bumps (nodules) that impede the tendon's motion even more.
Factors that put you at risk of developing trigger finger include:
- Repeated gripping. Occupations and hobbies that involve repetitive hand use and prolonged gripping may increase your risk of trigger finger.
- Certain health problems. People who have diabetes or rheumatoid arthritis are at higher risk of developing trigger finger.
- Your sex. Trigger finger is more common in women.
You'll probably start by seeing your family doctor or regular health care provider to determine what could be causing your symptoms.
What you can do
Make sure to bring a list of all the medications and supplements you take regularly. You might also want to write down some questions for your doctor in advance. Examples may include:
- Is this condition temporary?
- What's causing my symptoms?
- What treatments are available?
- Are there complications associated with this condition or its treatments?
What to expect from your doctor
Your doctor or health care provider is likely to ask you a number of questions. Being ready to answer them may reserve time to go over important information a second time.
Questions your doctor might ask include:
- What symptoms are you experiencing?
- How long have you been experiencing these symptoms?
- Do your symptoms seem to come and go, or are they persistent?
- Does anything seem to make your symptoms better?
- Does anything seem to make your symptoms worse?
- Are your symptoms worse in the morning or at any particular time of the day?
- Do you perform repetitive tasks on the job or for hobbies?
- Have you recently experienced any injury to your hand?
Diagnosis of trigger finger doesn't require any elaborate testing. Your doctor or health care provider makes the diagnosis based on your medical history and a physical exam. During the physical exam, your doctor will ask you to open and close your hand, checking for areas of pain, smoothness of motion and evidence of locking. Your doctor will also feel your palm to see if there is a lump present. If the lump is associated with trigger finger, the lump will move as the finger moves because the lump is attached to the tendon that moves the finger.
Trigger finger treatment varies depending on its severity and duration.
Nonsteroidal anti-inflammatory drugs — such as ibuprofen (Advil, Motrin IB) or naproxen (Aleve) — may relieve the pain but are unlikely to relieve the swelling constricting the tendon sheath or trapping the tendon.
Conservative noninvasive treatments may include:
- Rest. For at least three to four weeks, avoid activities that require repetitive gripping, repeated grasping or the prolonged use of vibrating hand-held machinery.
- Ice or heat. Some people experience improvement by icing the palm several times a day. Others see more benefit with warm-water soaks, particularly first thing in the morning.
- A splint. Your doctor may have you wear a splint at night to keep the affected finger in an extended position for up to six weeks. The splint helps rest the tendon. Splinting also helps prevent you from curling your fingers into a fist while sleeping, which can make it painful to move your fingers in the morning.
- Stretching exercises. Your doctor may also suggest gentle exercises to help maintain mobility in your finger.
Surgical and other procedures
If your symptoms are severe or if conservative treatments haven't helped, your doctor might suggest:
- Steroid injection. An injection of a steroid medication near or into the tendon sheath may reduce inflammation and allow the tendon to glide freely again. This is the most common treatment, and in people who do not have diabetes, it is effective in up to 90 percent of patients. In people with diabetes, it is effective about half the time. Sometimes to obtain these results, a second injection is needed.
- Percutaneous release. After numbing your palm, your doctor inserts a sturdy needle into the tissue around your affected tendon. Moving the needle and your finger helps break apart the constriction that's blocking the smooth motion of the tendon. This treatment may be done under ultrasound control, so the doctor can see where the tip of the needle is under the skin to be sure it opens the tendon sheath without damaging the tendon or nearby nerves. This procedure is usually done in the doctor's office or procedure room.
- Surgery. Working through a small incision near the base of your affected finger, a surgeon can cut open the constricted section of tendon sheath. This procedure is usually done in an operating room.
Aug. 27, 2014
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