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Trigger Finger: Causes, Symptoms & Treatment
Trigger finger is a condition affecting the flexor tendon of a finger, causing it to snap, catch, or lock when bending or straightening.
Add as Preferred SourceThings worth knowing about "Trigger finger"
Trigger finger is a condition affecting the flexor tendon of a finger, causing it to snap, catch, or lock when bending or straightening.
What is Trigger Finger?
Trigger finger (medically known as stenosing tenosynovitis or digitus saltans) is a common hand condition in which the flexor tendon of a finger can no longer glide smoothly through a narrowed section of its tendon sheath. When bending or straightening the affected finger, a characteristic snapping, catching, or locking sensation occurs. In severe cases, the finger may become completely locked in a bent position and can only be straightened with assistance from the other hand.
Causes
The condition is caused by a thickening of the first annular pulley (the A1 pulley) at the base of the finger, through which the flexor tendon must pass. Several factors can trigger this thickening:
- Repetitive strain: Repeated gripping or pressing movements, for example in manual work or crafts
- Metabolic conditions: Diabetes mellitus, rheumatoid arthritis, and thyroid disorders significantly increase the risk
- Idiopathic onset: In many cases, the condition arises without a clear identifiable cause
- Age and gender: Women in middle to older age are more frequently affected
Symptoms
Symptoms typically develop gradually and worsen without treatment:
- Pain at the base of the finger, particularly over the knuckle joint
- Audible or palpable snapping or clicking when bending or extending the finger
- Increased stiffness and pain in the morning
- A palpable nodule or thickening at the base of the finger
- In advanced stages: complete locking of the finger in a flexed position
Diagnosis
Trigger finger is usually diagnosed clinically, meaning through physical examination. A physician palpates the metacarpophalangeal joints and observes finger movement. Ultrasound imaging can visualize the thickened pulley and rule out other causes. Advanced imaging such as MRI or X-ray is rarely required.
Treatment
Conservative Treatment
In mild to moderate cases, non-surgical treatment options are available:
- Splinting: Immobilizing the affected finger to reduce strain on the tendon
- Physiotherapy: Stretching and strengthening exercises to improve range of motion
- Corticosteroid injection: An injection of a corticosteroid into the tendon sheath can reduce inflammation and swelling of the pulley. This is a commonly used and effective method.
- Anti-inflammatory medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) can help relieve pain
Surgical Treatment
If conservative measures are insufficient or the finger remains permanently locked, a minor surgical procedure is recommended:
- Open pulley release: Under local anesthesia, the constricting A1 pulley is divided through a small incision at the base of the finger, allowing the tendon to glide freely again.
- Percutaneous needle release: In this minimally invasive technique, the pulley is divided using a fine needle without a skin incision.
Both methods have very high success rates and generally lead to complete resolution of symptoms.
References
- Huisstede, B. M. et al. - Trigger Finger: A Systematic Review of Treatments. Archives of Physical Medicine and Rehabilitation, 2018.
- Makkouk, A. H. et al. - Trigger Finger: Etiology, Evaluation, and Treatment. Current Reviews in Musculoskeletal Medicine, 2008.
- Ryzewicz, M. & Wolf, J. M. - Trigger Digits: Principles, Management, and Complications. Journal of Hand Surgery, 2006.
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