James B. Grimes, MD
mis med pro

Trigger Finger

Trigger Finger web based movie

The ability to bend the fingers is governed by supportive tendons that connect muscles to the bones of the fingers. The tendons run along the length of the bone and are kept in place at intervals by tunnels of ligaments called pulleys.

Trigger finger is a painful condition that causes the fingers or thumb to catch or lock when bent. The affected digit may straighten with a quick snap, similar to pulling and releasing the trigger on a gun, hence the name trigger finger. In the thumb, it’s called trigger thumb.

Trigger finger happens when tendons in the finger or thumb become inflamed and swollen. Tendons are tough bands of tissue that connect muscles and bones. Together, the tendons and muscles in the hands and arms bend and straighten the fingers and thumbs.

A tendon usually glides easily through the tissue that covers it (called a sheath) because of a lubricating membrane surrounding the joint called the synovium. Sometimes a tendon may become inflamed and swollen. When this happens, bending the finger or thumb can pull the inflamed tendon through a narrowed tendon sheath, making it snap or pop.


Inflammation of the flexor tendon causes a swollen segment that makes it difficult for the tendon to glide smoothly within its sheath. This causes “catching” of the finger when it is bent. The finger may get stuck in a bent position. Early in the condition, it may be possible to actively straighten the finger that is catching. This may result in a sudden release that allows straightening of the finger. As the condition worsens, you may have to use your other hand to straighten the locked trigger finger.

Other causes of trigger finger can include the following:

Repetitive Motion: Individuals who perform heavy, repetitive hand and wrist movements with prolonged gripping at work or play are believed to be at high risk for developing trigger finger. Farmers, industrial workers, and musicians often get trigger finger since they repeat finger and thumb movements a lot. Even smokers can get trigger thumb from repeated use of a lighter, for example. Trigger finger is more common in women than men and tends to happen most often in people who are 40 to 60 years old.

Medical Conditions: Conditions associated with developing trigger finger include hypothyroidism, rheumatoid arthritis, diabetes, and certain infections such as Tuberculosis.

Gender: Trigger finger is more common in females than males.

Signs and Symptoms

Commonly reported symptoms associated with trigger finger include the following:

  • Soreness in the palm at the base of the finger or thumb.
  • Pain and tenderness over inflamed tendon
  • Bent finger suddenly pops out and straightens
  • “Popping” or “clicking” sound or sensation when the nodule moves through the pulley
  • Finger feels stiff and sore
  • Finger get locked with inability to straighten when the nodule grows large and gets stuck in the pulley
  • Symptoms are worse in morning

Long-term complications of untreated trigger finger can include permanent digit swelling and contracture, as well as tearing of the tendon or rupture


Hand and wrist conditions should be evaluated by an orthopaedic surgeon for diagnosis and treatment. Trigger finger is diagnosed based on the medical history and physical examination. X-rays of your hand may be obtained to determine whether your hand bones and joints are normal and to evaluate whether there is arthritis.


Your surgeon may recommend conservative treatment options to treat trigger finger symptoms. Treatment options will vary depending on the severity of the condition.

Conservative treatment options may include the following:

  • Treating any underlying medical conditions that may be causing the problem, such as diabetes or arthritis
  • Rest the hand for 2-4 weeks or more by avoiding repetitive gripping actions. Avoid activities that tend to bring on the symptoms.
  • Strengthening and stretching exercises with the affected finger may be suggested.
  • Occupational therapy may be recommended for massage, heat, ice and exercises to improve the finger.
  • Ice over the affected finger may help symptoms. Apply ice over a towel for 5-15 min, 3-4 x daily.
  • Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen may help to relieve pain and inflammation.
  • Cortisone injections into the tendon sheath of the affected finger or thumb may help reduce the inflammation.

If conservative treatment options fail to resolve the condition and symptoms persist and your quality of life is adversely affected, your surgeon may recommend you undergo a surgical procedure to release the tendon.

Percutaneous trigger finger release surgery is a minimally invasive procedure performed under local or general anesthesia. Your surgeon makes one small incision in the palm and releases the tight portion of the flexor tendon sheath.


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