Trigger Finger or Thumb

Trigger finger/thumb refers to a condition where the tendons in the fingers or thumb are unable to glide smoothly through the surrounding sheath. This can make it hard to twist or straighten the affected finger; in some cases, the digit may get stuck in a bent position. Also referred to as stenosing tenosynovitis, the trigger finger/thumb often occurs in the ring or little fingers, as well as the thumb.

Symptoms

Symptoms of the trigger finger normally develop progressively, often without any obvious injury. They are commonly triggered by intense or repeated use of the hand, especially activities that involve pinching or gripping.

Common symptoms include:

• A tender bump at the finger or thumb base on the hand’s palm region.
• A popping, catching, or locking feeling when moving the affected finger or thumb.
• Pain when trying to bend or straighten the digit.

Causes & Risk Factors

The actual causes of the trigger finger/thumb remain unclear, but several factors are thought to increase the likelihood of the condition. These include:

• Health conditions: People with conditions like diabetes and rheumatoid arthritis are at a higher risk of developing trigger finger.
• Forceful hand activities: Intense finger or thumb use can lead to the condition.
• Age: Trigger finger/thumb is rare in children and more common among older adults, especially women. Nevertheless, a congenital trigger thumb may contribute to a child’s thumb locking in a bent position.

Diagnosis

At The Joint Pain Clinic, we often diagnose the trigger finger/thumb by reviewing your symptoms and conducting a physical examination of your hand. During the exam, your clinician will look for:

• Sensitivity above the flexor tendon sheath in the hand’s palm.
• Thickening or inflammation of the tendon sheath at the finger or thumb base.
• A clicking or catching feeling when bending or straightening the finger or thumb.

Treatment

Our initial treatment approach for trigger finger mainly focuses on non-surgical methods, which include:

• Resting: Allowing your hand to rest and avoiding activities that worsen the symptoms can help reduce discomfort.
• Exercising: Mild stretching exercises can help ease stiffness and improve mobility in the affected digit.
• Steroid injections: Corticosteroid injections are administered into the tendon sheath at the base of the affected finger or thumb. These injections are a powerful anti-inflammatory treatment, and often, one injection may resolve the issue. If symptoms improve but then persist or return, a second injection can be recommended.

If two steroid injections, rest, and exercise fail to provide long-term relief, surgical intervention is usually required.