Digital stenosing tenosynovitis; Trigger digit; Trigger finger release
What is a trigger finger?
Trigger finger occurs when a finger or thumb gets stuck in a bent position, as if you were squeezing a trigger. Once it gets unstuck, the finger pops straight out, like a trigger being released.
In severe cases the finger cannot be straightened. Surgery is needed to correct it.
About trigger finger
Tendons connect muscles to bones. When you tighten a muscle, it pulls on the tendon, and this causes the bone to move.
The tendons that move your finger slide through a tendon sheath (tunnel) as you bend your finger.
- If the tunnel swells, has a bump on it, or is swollen, the tendon cannot slide smoothly through the tunnel.
- When it cannot slide smoothly, the tendon may become stuck when you try to straighten your finger.
If you have a trigger finger, you may notice:
- Your finger is stiff or it locks in a bent position.
- You have painful snapping or popping when you bend and straighten your finger.
- Your symptoms are worse in the morning.
- You have a tender bump on the palm side of your hand at the base of your finger.
Trigger finger can occur in both children and adults. It is more common in people who:
- Are over 45
- Are female
- Have diabetes, rheumatoid arthritis, or gout
- Do work or activities that require repeated gripping of their hands
Trigger finger is diagnosed by medical history and a physical exam. Trigger finger does not require x-rays or lab tests.
Treating trigger finger without surgery
In mild cases, the goal is to decrease swelling in the tunnel.
- Your doctor may tape your finger to one of your other fingers (called buddy taping).
- You may wear a splint at night for a few weeks.
- Applying heat and ice and stretching may also be helpful.
Your doctor may also give you a shot of a medicine called cortisone. The shot goes into the tunnel that the tendon goes through. This can help decrease swelling. Your doctor may try a second shot if the first one does not work.
Surgery for trigger finger
You may need surgery if your finger is locked in a bent position or does not get better with treatment. The surgery is done under local anesthesia or a nerve block to prevent pain. You may be awake during surgery.
During the surgery:
- Your surgeon will make a small cut in your skin just below the tunnel of your trigger finger.
- Next, your surgeon will make a small cut in the tunnel (sheath covering the tendon) and then ask you to move your finger.
- Once you can move your finger, your surgeon will close your skin with stitches and put compression or tight bandage on your hand.
- Keep the bandage on for 48 hours. After that, you can use a simple bandage, like a Band-Aid.
- After about 2 weeks your stitches will be removed.
- You can use your finger normally once it has healed.
When to call the doctor
If you notice signs of infection, call your surgeon right away. Signs of infection include:
- Redness in your incision or hand
- Swelling or warmth in your incision or hand
- Yellow or green drainage from the incision
- Hand pain or discomfort
If your trigger finger returns, call your surgeon. You may need another surgery.
Calandruccion JH. Carpal tunnel syndrome, ulnar tunnel syndrome, and stenosing tenosynovitis. In: Canale ST, Beaty JH, eds. Campbell's Operative Orthopaedics. Philadelphia, PA: Elsevier Mosby; 2012:chap 76.
Silver JK. Trigger finger. In: Frontera WR, Silver JK, Rizzo TD, eds. Essentials of Physical Medicine and Rehabilitation. 2nd ed. Philadelphia, PA: Elsevier Saunders; 2008: chap 33.
Reviewed By: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.