Trigger Finger

Understanding and Treating Trigger Finger

If you’ve noticed stiffness, clicking or locking in one of your fingers, you could be experiencing trigger finger. A condition that affects people of all ages and activity levels. Often caused by repetitive gripping or inflammation around the tendons, this can make even simple tasks like holding a cup or typing uncomfortable. Whether you're an athlete or someone developing symptoms without a clear cause, recognizing the signs early is key to preventing long-term discomfort. Learn more about trigger finger at Forté Sports Medicine and Orthopedics, with treatment centers in Carmel, Greenwood, Mooresville, Noblesville and Tipton, IN. 

What is Trigger Finger? 

Trigger finger is a very common and treatable problem. It can happen in both fingers as well as the thumb, which have tendons that help them bend. The flexor tendons and their lining, called tenosynovium, are designed to glide through structures called pulleys without any friction.  A trigger finger can occur if the tendon enlarges, the lining increases in thickness, or if the pulley becomes thicker.  This condition is also called tenosynovitis. The changes can cause the tendon to have difficulty moving back and forth as the finger bends and straightens. Trigger finger can be diagnosed by a patient’s history, symptoms and a physical exam.  

What Causes Trigger Finger? 

Trigger fingers are more common with certain medical conditions. Rheumatoid arthritis, gout, and diabetes are common risk factors for this condition. Repeated, strong gripping may lead to this condition, but in most cases, the cause of trigger finger is not known.  

“The flexor tendons typically glide nicely through a series of tunnels, called pulleys.  When there is a mismatch between the size of the tendons and the pulleys, patients usually notice pain in the palm at the base of the finger and stiffness with movement.  As this progresses, the thickened tendon or lining can develop a nodule that then “pops” from one side of the first pulley to the other, which causes the triggering sensation,” says.

Dr. Toni Lin, an orthopedic surgeon at Forté Sports Medicine who specializes in conditions related to tendons, nerves, fractures and arthritis.

What are the Symptoms of Trigger Finger? 

Some symptoms may include: 

• Pain: Trigger finger can start with discomfort felt at the base of the affected finger or thumb, where the finger joins the palm. This may be the only symptom at first. This pain occurs with pressure over the A1 pulley area. Pain may only present with activity such as gripping and use.  
• Swelling: Over time, there may be a lump or knot at the A1 pulley. This can be due to a nodular swelling within the tendon. There can also be the development of a fluid-filled cyst. This cyst is called a flexor sheath ganglion or retinacular cyst. 
• Stiffness: A trigger finger may result in loss of the ability to bend the finger. This can be estimated by how far the tip of the finger is from the palm when the patient is asked to bend their finger. This is commonly seen in chronic cases. It can be painful to bend the finger due to the compression of fluid. Over time, the person may start to avoid a bent position to limit their finger pain.  
• Mechanical symptoms: A trigger finger can cause abnormal sensations or movement, often described as popping, catching or locking. Sometimes these abnormal sensations occur when bending or straightening the finger. Pain can increase over time.  

 
What are the Treatment Options? 

There are surgical and nonsurgical treatment options for trigger finger. Non-surgical treatment includes: 

• Splinting at night: Many patients find that their trigger fingers are locked or stuck in when they wake because the digits are not moving throughout the night as they do during the day. It can be very painful to unlock or straighten the fingers. Using a night splint to keep the finger straight can prevent locking. However, keeping the finger straight all night could result in the need to spend more time and effort getting it to move smoothly in the morning.  
• Nonsteroidal anti-inflammatory drugs: Oral or topical anti-inflammatory medication can be used to relieve pain and improve ability to move the finger.  
• Activity: It may be possible to limit or space out the amount of time spent forcefully or repetitively gripping.  
• Steroid injection: Corticosteroid injections can be given at any stage of symptoms but may have more success when given early.  
• Hand therapy: Patients may benefit from some supervised and home exercises. It can be helpful to have a hand therapist teach concepts and techniques such as passive joint motion, tendon differential gliding, edema control and more.  
• If nonsurgical treatments do not relieve the symptoms, surgery may be recommended. The goal of surgery is to open the pulley at the base of the finger so that the tendon can move more freely. The clicking and popping go away in most cases after cutting the A1 pulley. If there are still mechanical symptoms after a trigger finger release, a flexor tenosynovectomy can be considered. With surgical treatment, the chances of recognizing and treating all changes to the finger are improved when the patient is awake at the end of the procedure. By having the patient bend and straighten their finger, the surgeon can verify that the mechanical symptoms are resolved. Finger motion can return at different times depending on the patient. Your hand surgeon will develop an individual treatment plan for you.  

Dr. Lin says that “Trigger finger is one of the most common conditions hand surgeons treat. We can often improve the pain and stiffness, and many times cure a trigger finger with a steroid injection. The success of an injection decreases if the condition has been chronic or the finger is locked.”

Schedule a Consultation at Forté Sports Medicine and Orthopedics Today   

If you are experiencing hand pain or finger stiffness and it is interfering with your ability to perform your daily activities, look to our team for assistance. We have convenient locations in Carmel, Greenwood, Mooresville, Noblesville and Tipton to serve you. Following a consultation, our hand experts will tailor a treatment plan that ensures the best possible outcome. Contact us today to get started.