In short,
- Trigger finger develops when inflammation narrows the tendon sheath, preventing smooth tendon gliding.
- Repetitive gripping, certain medical conditions, and anatomical factors increase risk.
- Early diagnosis and appropriate treatment restore finger function and prevent progression.
Understanding Trigger Finger
Trigger finger, medically known as stenosing tenosynovitis, causes your finger or thumb to catch or lock when you bend it. The main reason for trigger finger is inflammation and narrowing of the tendon sheath that surrounds the flexor tendon in your finger.
This creates a catching sensation as the tendon struggles to glide smoothly through the constricted sheath, eventually causing the characteristic popping or locking that gives the condition its name.
How Trigger Finger Develops
Your fingers contain flexor tendons that run from your forearm through tunnels in your hand and fingers, allowing you to bend them. These tendons glide through protective sheaths that keep them in place and lubricate their movement. When the tendon sheath becomes inflamed and thickened, it narrows the space available for the tendon to pass through.
As inflammation progresses, a nodule or bump may form on the tendon itself. When you try to straighten your finger, this nodule catches on the narrowed sheath opening, causing the locking sensation. With forceful straightening, the nodule suddenly pops through, and your finger snaps straight. This is similar to tendinitis of the hand but involves the specific mechanism of tendon catching rather than just inflammation.
Primary Risk Factors
Several factors increase your likelihood of developing trigger finger. Repetitive gripping activities from occupational or recreational tasks that require prolonged or forceful gripping stress the flexor tendons and sheaths. Jobs involving power tools, assembly line work, or musical instruments create repeated stress.
Medical conditions significantly influence risk. Diabetes substantially increases trigger finger incidence. Rheumatoid arthritis and other inflammatory conditions that affect connective tissues also elevate risk. Carpal tunnel syndrome frequently coexists with trigger finger.
Age and gender play roles, with trigger finger most commonly affecting people between 40 and 60 years old. Women develop the condition more frequently than men. Previous hand injuries or surgery can alter anatomy in ways that predispose to trigger finger development.
Recognizing Trigger Finger Symptoms
Symptoms typically develop gradually and worsen over time. Early signs include stiffness in the affected finger, particularly noticeable in the morning, pain or tenderness at the base of the finger in the palm, and a small lump or nodule you can feel in the palm.
As the condition progresses, you’ll notice clicking or popping when moving the finger, the finger catching in a bent position before suddenly releasing, difficulty fully straightening or bending the finger, and pain that worsens with gripping activities. In severe cases, the finger may become locked in a bent position and unable to straighten without assistance.
While trigger finger causes catching and locking, a finger that is tingling suggests possible nerve involvement and should prompt evaluation for conditions like carpal tunnel syndrome or nerve compression.
Diagnosis Process
Diagnosis typically doesn’t require imaging or laboratory tests. Your hand specialist performs a physical examination, feeling for nodules in your palm, observing finger movement to identify catching or locking, assessing pain location and severity, and evaluating grip strength and range of motion.
The characteristic catching sensation combined with a palpable nodule usually confirms the diagnosis.
Conservative Treatment Approaches
Most cases respond well to non-surgical treatment, especially when addressed early.
Rest and activity modification reduce inflammation by avoiding repetitive gripping and forceful hand use.
Splinting keeps the affected finger in a straight position, particularly at night, allowing the tendon sheath to heal.
Anti-inflammatory medications, including ibuprofen or naproxen, help reduce pain and swelling.
Corticosteroid injections deliver powerful anti-inflammatory medication directly into the tendon sheath, providing significant relief for many patients. Success rates for injections were found to be 66%, with better results in less severe cases and patients without diabetes.
When Surgery Becomes Necessary
Surgical intervention becomes appropriate when conservative treatments fail to provide adequate relief after several months, the finger remains locked and cannot be straightened manually, symptoms significantly impair daily function, or multiple injections have provided only temporary improvement.
Trigger finger release surgery is a brief outpatient procedure that opens the constricted portion of the tendon sheath, allowing the tendon to glide freely. The procedure takes about 15 minutes and typically uses local anesthesia. Most patients achieve complete symptom resolution with surgery.
Recovery and Rehabilitation
Recovery from conservative treatment varies. Splinting and rest may provide improvement within two to six weeks. Corticosteroid injections often relieve symptoms within days to weeks, though effects may be temporary.
Surgical recovery involves initial wound healing over one to two weeks, progressive hand use as comfort allows, and hand therapy if needed to restore full motion and strength. Most people return to normal activities within three to six weeks, though full recovery may take several months.
Preventing Trigger Finger
While not all cases are preventable, certain strategies reduce risk. Take frequent breaks during repetitive hand activities. Use ergonomic tools with padded handles that reduce grip force requirements. Stretch and strengthen hand and finger muscles regularly.
Address underlying conditions like diabetes through proper management. Avoid prolonged forceful gripping when possible.
Living With Trigger Finger
Managing trigger finger involves balancing activity with rest. Modify gripping activities to reduce stress on affected fingers. Apply heat before activity to relax tissues and improve flexibility. Use cold therapy after activity to reduce inflammation.
Perform gentle stretching exercises to maintain flexibility. Consider ergonomic modifications at work or home to reduce repetitive stress.
When to Seek Evaluation
Consult a hand specialist if you experience persistent finger stiffness or pain, catching or clicking that interferes with daily activities, visible nodules at the base of fingers, or fingers that lock in bent positions. Early intervention prevents progression and typically allows for successful conservative treatment.
Understand the Reason for Your Trigger Finger and Get Expert Hand Care in Baltimore, MD
At Greater Chesapeake Hand to Shoulder, our specialized hand surgeons provide comprehensive evaluation and treatment for trigger finger and other hand conditions. We offer both conservative and surgical treatment options, tailoring our approach to your specific needs and goals.
Our expertise in hand disorders ensures you receive the most effective care available, helping you return to comfortable hand function as quickly as possible.
Call Greater Chesapeake Hand to Shoulder today at (410) 296-6232 or schedule your consultation online and begin your path to relief.
