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Trigger Finger and Trigger Thumb
Understanding why a finger or thumb catches, clicks or locks, and the treatment options available, from simple measures through to surgery.
What is Trigger Finger and Trigger Thumb?
Trigger finger and trigger thumb happen when a flexor tendon, which normally glides smoothly through a tunnel of pulleys to bend the finger, becomes irritated and swollen where it passes through the first pulley (the A1 pulley) at the base of the finger or thumb. The tendon then catches or snaps as it tries to pass through the narrowed tunnel, causing the finger to click, lock, or become stuck in a bent position.
Trigger Finger and Trigger Thumb at a glance
What is it?
A flexor tendon catching as it moves through a narrowed pulley at the base of the finger or thumb
Common symptoms
Catching, clicking or locking of the finger or thumb, often worse in the morning
Who it affects
More common in women, in people with diabetes, and with repetitive gripping
Is it serious?
Not dangerous, but a finger can become stuck bent if left untreated
Treatment options
Splinting, activity modification, corticosteroid injection, or surgery
First step
A consultation to confirm which finger and pulley is involved
Symptoms and how Trigger Finger and Trigger Thumb presents
The main symptom is a catching, clicking or locking sensation as you bend or straighten the finger or thumb, often worse first thing in the morning and easing during the day.
There is usually a tender lump you can feel in the palm at the base of the affected digit. In more advanced cases the finger can lock in a bent position and need to be straightened with the other hand.
Causes and risk factors for Trigger Finger and Trigger Thumb
- No known cause or risk factor
- Repetitive or forceful gripping
- Diabetes
- Rheumatoid arthritis or gout
- A tendency to also have carpal tunnel syndrome
- Thickening of the tendon sheath, often without a clear cause
How is Trigger Finger and Trigger Thumb diagnosed?
Trigger finger is usually diagnosed from your history and a hand examination. Dr Tomlinson will feel for a tender nodule at the base of the finger and watch the finger bend and straighten to confirm the catching. Imaging is not usually needed.
Treatment options for Trigger Finger and Trigger Thumb
Mild symptoms are often helped by resting the hand and avoiding repetitive gripping.
A corticosteroid injection into the tendon sheath is a common and often effective treatment, though it can need repeating. Dr Tomlinson generally administers a corticosteroid injection for trigger fingers at an individual’s first appointment for a trigger digit, unless the patient does not wish to try this, or there are contraindications to the injection. The injection administered is a combination of local anaesthetic and corticosteroid, and you can drive afterwards and return to work if you wish.
If symptoms persist or the finger is locking, trigger finger release surgery is usually recommended. This is a common day procedure that divides the tight pulley so the tendon can move freely again.
When to see a hand surgeon about Trigger Finger and Trigger Thumb
It is worth seeing a hand surgeon if a finger or thumb is catching, clicking or locking, especially if it is becoming stuck in a bent position or is not improving with rest and simple measures.
What to expect at your Trigger Finger and Trigger Thumb appointment
At your appointment, Dr Tomlinson will examine your hand and confirm the diagnosis. She may offer an injection at the same visit, or discuss surgery if your symptoms are more advanced or have not responded to other treatment.
Watch: Understanding Trigger Finger and Trigger Thumb
Frequently Asked Questions
What is trigger finger?
A flexor tendon catching as it tries to pass through a narrowed pulley at the base of the finger or thumb, causing the finger to click, catch or lock.
What causes it?
Often the tendon develops a nodule and the sheath simply thickens with no clear single cause. Repetitive or forceful gripping, diabetes, rheumatoid arthritis or gout, and a tendency to also have carpal tunnel syndrome are associated with trigger finger.
What can I do myself?
Resting the hand and avoiding repetitive or forceful gripping can help mild symptoms settle. If the finger is catching persistently or starting to lock, it’s worth having it assessed rather than waiting.
What can a hand therapist do?
Advise on activity changes and splinting where appropriate, and support recovery with therapy after surgery if needed.
What can a hand surgeon do?
Confirm the diagnosis on examination and, in most cases, offer a corticosteroid injection at your first appointment. If symptoms persist or the symptoms are very troublesome, trigger finger release surgery, a day procedure that divides the tight pulley, is usually recommended.
What can I expect from treatment?
An injection often settles symptoms, though it can need repeating. Trigger finger release is a common, well-established day procedure aimed at freeing the tendon so the finger moves smoothly again. Some stiffness or tenderness around the wound in the early weeks is normal.
What happens if it's left untreated?
Symptoms can wax and wane and sometimes settle with rest, but if the pulley stays narrowed the finger can become increasingly restricted and eventually lock in a bent (or straight) position that needs to be moved manually, or cannot be actively moved.
Related conditions and treatments
Trigger finger involves a tendon catching, which is different from Dupuytren’s disease, where a cord in the palm tightens and pulls the finger in. It is possible to have both Dupuytren’s disease and trigger finger as a cause for your hand symptoms. If you also have numbness or tingling in the hand, this may be a separate condition such as carpal tunnel syndrome, which can occur alongside trigger finger.