Trigger Finger

Trigger finger, also known as stenosing tenosynovitis, is a result of scarring or inflammation between the tendon and its surrounding sheath. It most often occurs in the ring finger and thumb, but can occur in other fingers. It is not associated with the conjured image of shooting as its name implies. Medical conditions such as diabetes or arthritis, repetitive gripping action or trauma can contribute to the inflammation and swelling of the tendon that results in trigger finger. Some trigger fingers can resolve on their own over a period of time while others develop further stiffness in the finger.

Pain is often reported in the knuckle between the junction of the hand and the affected finger, or at the joint nearest the tip of the thumb fingernail, but the underlying condition is usually localized nearer the middle of the finger. 

Causes of trigger finger

There are pulleys and tendons in your hand that allow your fingers to bend. The tendons are like ropes that connect the muscles from your arm to your bones in your fingers and thumb. The pulleys are rings that make a tunnel for the tendon to glide through and they hold the tendons close to the bone. When the pulley become thick at the base of the finger or thumb, the tendon is not able to move as easily as it should. If the tendon is inflamed and becomes swollen, it is hard to straighten or bend the finger, resulting in trigger finger. 

It is often hard to determine the exact cause of trigger finger. Trauma to the base of the finger, arthritis, gout and diabetes may be factors in some cases.

Symptoms of trigger finger

When a single finger locks into a position where you are not able to straighten or bend it, you likely have trigger finger. In addition to this stiffness, you may also have one or more of these signs:

• Pain or tenderness at the base of the finger or thumb
• A nodule or bump at the base of the finger
• Swelling of the entire digit
• Pain at the finger’s middle joint

Diagnosis of trigger finger

Aside from the visual observation of the immobile finger, your physician will perform a thorough history and physical exam to definitively determine your diagnosis. 

Treating trigger finger
If symptoms are persistent, painful and affect activity of daily living, it’s time to see a doctor. Home treatment of trigger finger, and prescribed treatment after a medical examination, may include: 

• Taking nonsteroidal anti-inflammatory medicine
• Wearing a splint for a short period 
• Changing your activities to limit motion
• Taping the affected finger to a healthy finger 

Surgery may only be necessary if pain inhibits your normal daily activity and symptoms are not well controlled with conservative measures. Surgery to relieve trigger finger is most often done as an outpatient procedure with local anesthetic. You may have some soreness initially post-surgery, but can resume normal activities such as driving and writing quickly and can expect a full recovery in approximately four to eight weeks. 

Why choose Ohio State for treatment of a trigger finger?

When treating your trigger finger, we start with the least invasive techniques first. However, injections are the most effective treatment of trigger finger. If injections aren’t effective and surgery is recommended, one of our hand surgeons who has extensive training will perform surgery in our procedure room with wide-awake anesthesia or in the operating room with sedation.