Finger Hand Thumb Trigger Finger

Ask a Doctor: Trigger Finger

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Dr. Sameer Puri answers your most important questions about stenosing tenosynovitis, also known as trigger finger.

My doctor told me I might have a “trigger finger.” What is that?

“Trigger finger,” or stenosing tenosynovitis, is a condition that causes pain, locking, popping or clicking of the fingers or thumb when the hand is opened or closed.

What causes trigger finger?

Muscles in your forearm attach to tendons that run all the way to the bones at the ends of your fingers. These muscles help you bend your fingers into a fist. In the hand, the tendons are held close to the bone by pulleys. If the pulleys become too tight or thick, or the tendon gets swollen, the tendon can get stuck. If the tendon cannot glide freely, trigger finger occurs.

What are some of the symptoms of trigger finger?

In its early stages, trigger finger can cause pain. Usually, it is tender on your palm where the finger joins the hand. Sometimes, you feel the pain further along or even on the back of the finger. You might feel like your hands or fingers are stiff or swollen. As it progresses, the tightness can cause the tendon to catch as it tries to glide, leading to a painful snapping sensation when making a fist or opening the hand. Eventually, the finger can get stuck where it is, making it really hard either to straighten or to bend it.

The symptoms are often worst in the mornings immediately after waking up and can occur in any of the fingers or thumbs.

Why did I get trigger finger?

No one knows exactly why this happens. People who have diabetes or other inflammatory conditions seem to be affected more frequently, but it can happen to anyone.

How can you treat trigger finger?

If caught in the early stages, a splint or oral anti-inflammatory medicines may be able to calm down the symptoms. After this, the first line of treatment is usually a small steroid injection into the sheath of the tendon. This helps to decrease the swelling and allow the tendon to glide smoothly again.

If you have had injections that did not work in the past, your symptoms have been happening for a long time, or your finger is stuck in place, your hand surgeon might discuss surgery with you. This involves releasing the pulley that is blocking the tendon(s) from gliding. Most patients are allowed to move the finger and use the hand immediately after surgery. In some cases, your doctor may recommend hand therapy after surgery, but many patients will not require formal therapy to regain their motion.


Learn more about Trigger Finger and other upper extremity conditions at www.HandCare.org.


Sameer Puri, MDSameer Puri, MD is an Assistant Professor in the Department of Orthopaedic Surgery at Loyola University Medical Center in Maywood, IL, specializing in hand and upper extremity surgery. He completed his orthopeadic surgery training in Boston at the Tufts Combined Orthopaedic Residency, and completed subspecialty training in hand and upper extremity surgery at the Hospital for Special Surgery in New York.

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8 Comments
  • September 3, 2017 at 6:48 AM
    Reply

    Thanks for sharing us this blog. it’s really helpful for us. Share similar blog more.

  • July 10, 2017 at 4:11 PM
    Reply

    Good article, I might add that symptoms can arise from trauma from the flexor tendons of the hands as well. For example, many baggage carriers get trigger fingers.

  • January 17, 2017 at 4:20 AM
    Reply

    Thank you for sharing this post, Dr. Puri. Trigger finger can be quite painful. Is it possible to cure trigger finger symptoms through exercise?

    • January 25, 2017 at 8:27 PM
      Reply

      Hyun Bae,
      Hello and sorry for the delay in response to your question. Your question about exercise and trigger fingers is an interesting one. I suspect that asking this question of a hand therapist may get you a different response, but in my experience I haven’t seen much success with exercise and a cure for trigger finger. Like any hand surgeon, I see trigger fingers in people frequently and many people do try to do exercises to encourage the tendons to glide and to keep the fingers from getting stiff. I think that the exercises to avoid stiffness are a good idea, but I haven’t seen a specific set of exercises reliably cure a trigger finger. Trigger fingers do sometimes spontaneously resolve. If you are interested in exercise to help your trigger finger, please feel free to try as long as your finger maintains good range of motion. The good news is that your hand surgeon has ways to treat a trigger finger.

  • Sara
    December 22, 2016 at 6:55 PM
    Reply

    Do you mind if I ask a question as well? I have been saving up to get the injections after the steroid pills didn’t work. I have trigger finger in every finger except 1 thumb and 1 pinky. Lately I have noticed waking up with swollen veins in my wrist that hurts alot when I bend it. Today I have a swollen vein in the palm of my hand that has a stabbing pain. Is this related to my trigger finger problems or is this something totally different? And I was wondering how long can I go putting off injections or surgery? Does trigger finger get any worse than it already is? Thanks sooo much! You have no idea how much this helps me!

    • January 25, 2017 at 8:44 PM
      Reply

      Hello Sara,
      It looks like it has been a few weeks since your question was posted so things may have already changed for you. From what you describe, it’s hard to say if this is related to your trigger finger or not. Your hand surgeon should be able to clarify things for you about the swollen area in your palm. It does sound like a good idea to see your hand surgeon again to discuss this in more detail.

      In general, trigger fingers can continue to cause long term problems and can sometimes cause permanent stiffness in the fingers. You should try to avoid permanent finger stiffness. Every person is different in how they experience a trigger finger and in how long it takes for the problem to develop and worsen. Most hand surgeons would tell you to treat your trigger fingers as soon as you can to avoid the stiffness that can sometimes occur. I hope that my response encourages you to go get your fingers working again!

  • Maria Garcellano
    July 22, 2016 at 2:02 PM
    Reply

    Can I ask a question rather than a comment.? I have my first steroids injections last April and now it’s hurting but not as severe. Should I have the next injections now or wait until it gets worst or more painful coz I read,there is a limit for the injections and I don’t want to maximize it until I can bear the pain Thank you kindly and hoping for your response.

    • July 27, 2016 at 8:04 AM
      Reply

      Hi Maria –
      Sorry for the delay in the response. I think you’ll hear differing opinions on this, but my usual practice is to go ahead and try the second injection if you’d like to once it’s clear the first isn’t working. Oftentimes, the problem is the cycle of inflammation that occurs. The tendon gets swollen, and gets stuck under a pulley in the sheath of the finger. Because it gets stuck, it gets more swollen, which causes it to get more stuck… and so on and so forth. One idea behind the injection is to get the swelling down, and help the tendon glide freely, and in doing so to hopefully break this cycle.
      When thought of in this way, I think a second injection can be helpful before the symptoms return too severely. However if your symptoms aren’t too severe and you’d prefer to hold out as long as you can, that’s not an unreasonable approach either.
      I hope that helps,
      Sameer Puri

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