Definition

Trigger finger is an inflammation of the synovial sheath that encloses the flexor tendons of the thumb and fingers. Tendons are the cords that connect bones to muscles in the body. Usually, tendons slide easily through the sheath as the finger moves.

In the case of trigger finger, however, the synovial sheath becomes swollen and the tendon cannot move easily through small pulleys in the finger, causing the finger to remain in a flexed (bent) position. In mild cases, the finger may be straightened with a pop, like a trigger being released. In severe cases, the finger becomes stuck in the bent position. Usually this condition can easily be treated; contact your doctor if you think you may have trigger finger.

Trigger Finger

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Causes

Often, the cause of trigger finger is unknown. However, many cases of trigger finger are caused by one of the following:

  • Overuse of the hand from repetitive motions
    • Computer operation
    • Machine operation
    • Repeated use of hand tools
    • Playing musical instruments
  • Inflammation caused by a disease

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

The following factors increase your chance of developing trigger finger:

  • Age: 40 to 60
  • History of repetitive hand motions for work or play
  • Sex: female
  • History of certain diseases:
    • Rheumatoid arthritis
    • Gout
    • Hypothyroidism

Symptoms

If you experience any of these symptoms do not assume it is due to trigger finger. Some of these symptoms may be caused by other health conditions. If you experience any one of them for a period of time, see your physician.

  • Finger or thumb stiffness
  • Finger, thumb, or hand pain
  • Swelling or a lump in the palm
  • Catching or popping when straightening the finger or thumb
  • Finger or thumb stuck in bent position

Diagnosis

Your doctor will ask about your symptoms and medical history, and perform a physical exam. The physical exam may include:

  • Asking you to move the affected finger or thumb
  • Feeling the hand and fingers

For severe cases of trigger finger, your doctor may refer you to a hand specialist.

Treatment

Talk with your doctor about the best treatment plan for you. The goals of treatment for tenosynovitis are to reduce swelling and pain and to allow the tendon to move freely with the tendon sheath. Treatment options include the following:

Rest

Stopping movement in the finger or thumb, sometimes with the help of a brace or splint, is often the best treatment for mild cases of trigger finger. Rest may be combined with stretching the muscle tendon unit involved.

Medications

Several medications are used to treat tenosynovitis. These include:

  • Corticosteroids, given as an injection into the synovial tendon sheath to reduce swelling of the tendon sheath
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) to help reduce inflammation and pain:
    • Ibuprofen (Advil, Motrin)
    • Naproxen (Aleve, Naprosyn)

For severe cases of trigger finger that do not respond to medications, surgery may be used to release the the tendon pulley of the finger from a locked position and to allow the tendon to move freely through the sheath. This surgery is usually performed on an outpatient basis and requires only a small incision in the palm of the hand.

Prevention

The most important action you can take to prevent trigger finger is to avoid overuse of your thumb and fingers. If you have a job or hobby that involves repetitive motions of the hand, you can take the following steps:

  • Adjust your workspace to minimize the strain on your joints
  • Alternate activities when possible
  • Take breaks throughout the day
  • Exercise regularly