Trigger finger, also known as stenosing tenovaginitis, is a common condition which can affect any of the fingers or the thumb. It can cause pain, clicking, catching or locking of the affected digit.
Mr Robert Farnell is an experienced specialist Consultant Orthopaedic Hand and Wrist Surgeon who has been working in Leeds for over 25 years. He exclusively treats conditions affecting the adult hand and wrist, including carpal tunnel syndrome, trigger finger and thumb, thumb arthritis and Dupuytren’s disease.
What is a trigger finger?
Trigger finger is a common, often painful condition that affects the flexor tendon as it passes through the tendon sheath in the finger. It is not thought to be an inflammatory condition, but may be due to degenerative changes affecting the flexor tendon sheath and surrounding tissues.
The condition can affect any finger. When it affects the thumb, it is known as trigger thumb. The affected finger or thumb may click, catch or become locked in a bent position.
Symptoms of trigger finger and thumb
The classical symptoms of trigger finger or trigger thumb include pain in the palm at the base of the finger or thumb, and episodes where the digit locks in a bent position.
Pain at the base of the finger or thumb
Pain is commonly experienced in the palm at the base of the affected finger or thumb. This area may also feel tender when pressed.
Clicking, catching or locking
Triggering usually occurs after making a fist. The finger or thumb may remain held in flexion and it can be difficult to straighten actively.
The finger can often be straightened by using the other hand. It may then straighten with a snap, which is the so-called “trigger”. This can be painful.
Symptoms can vary
Not everyone experiences the classical symptoms. Some patients describe pain at the back of the finger over the proximal interphalangeal joint, which is the first finger knuckle joint. Others describe a clicking sensation, or believe that the joint may be dislocating during movement.
How is trigger finger diagnosed?
Your surgeon will usually make the diagnosis clinically, based on your symptoms and examination findings. Further investigations are not usually necessary.
During your appointment, Mr Farnell will assess the affected finger or thumb, check for tenderness, triggering, stiffness and locking, and discuss the most appropriate treatment options.
Find out what to expect at your outpatient appointment.
Treatment for trigger finger and thumb
Treatment depends on the severity of symptoms, whether the finger or thumb is locking, how long symptoms have been present and whether non-surgical treatment has already been tried.
Non-surgical treatment
Symptoms may improve with non-surgical treatment. This may include wearing a splint, taking oral anti-inflammatory medication or having a cortisone injection into the flexor tendon sheath. Injections are reasonably successful, but do not always last.
Surgical treatment
Surgery may be recommended if the finger is in a permanently flexed position or if non-surgical treatment has been unsuccessful. Some patients choose surgery as their first treatment because it has a more predictable outcome.
The operation is called a trigger finger release. It is a relatively minor procedure which is usually performed under local anaesthetic as a day case.
A small incision is made in the palm at the base of the affected finger or thumb. The surgeon releases the narrowing around the tendon. This relieves the constriction as the tendon passes through the sheath and stops the triggering immediately.
The procedure takes approximately ten minutes on average. Following surgery, a light dressing is applied to protect the wound while allowing early active movement of the fingers and thumb.
Recovery after trigger finger surgery
Trigger finger release is usually well tolerated. Symptoms of locking are usually relieved immediately after surgery.
Patients can expect some discomfort from the incision for several weeks. Discomfort from deep pressure may continue for several months.
A full recovery is expected within a few months after surgery. Most people can return to normal activities within two to three weeks, although heavier activities may need to be restricted for four to six weeks.
The dressing will remain in place for up to two weeks after the operation. It is recommended that the hand is kept dry during this period.
Read more about post-operative care.
Possible complications of surgery
Complications after trigger finger release are uncommon and are usually minor.
- Wound infection, which occurs in approximately 1% of cases
- Temporary scar tenderness, which is the most common problem
- Finger stiffness, which is uncommon
- Nerve injury, which is very uncommon and usually temporary
Concerned about a clicking or locking finger?
If you have pain, clicking, catching or locking in a finger or thumb, Mr Robert Farnell can assess your symptoms and advise whether splinting, injection treatment or surgery may be appropriate.
Trigger finger and thumb FAQs
These answers are provided to help patients understand the key points about trigger finger, trigger thumb and treatment options.
What is trigger finger?
Trigger finger is a condition where a finger catches, clicks or locks as it bends and straightens. It can affect any finger and may be painful.
What is trigger thumb?
Trigger thumb is the same condition affecting the thumb. The thumb may click, catch or lock in a bent position.
What causes trigger finger?
Trigger finger may be due to degenerative changes affecting the flexor tendon sheath and surrounding tissues. The tendon becomes restricted as it passes through the sheath in the palm.
What are the symptoms of trigger finger?
Common symptoms include pain in the palm at the base of the finger or thumb, clicking, catching and episodes where the finger or thumb locks in a bent position.
Can trigger finger affect more than one finger?
Yes. Trigger finger can affect any finger or the thumb. Some patients may have more than one affected digit.
How is trigger finger diagnosed?
Trigger finger is usually diagnosed clinically from the symptoms and examination findings. Further investigations are not usually required.
Can trigger finger be treated without surgery?
Yes. Non-surgical options may include splinting, oral anti-inflammatory medication or a cortisone injection into the flexor tendon sheath. These treatments may only provide temporary improvement.
When is surgery recommended for trigger finger?
Surgery may be recommended if the finger is permanently flexed, if symptoms are troublesome or if non-surgical treatment has not worked.
What is trigger finger release surgery?
Trigger finger release is a minor operation where a small incision is made in the palm and the narrowing around the tendon is released. This allows the tendon to move freely and stops the triggering.
How long does trigger finger surgery take?
Trigger finger release takes approximately 10 minutes on average and is usually performed under local anaesthetic as a day case procedure.
How long does recovery take after trigger finger release?
Locking usually improves immediately after surgery. Most people return to normal activities within two to three weeks, although heavier activities may be restricted for four to six weeks. Full recovery is expected within a few months.