Trigger Finger

What Is Trigger Finger?

Trigger finger, or stenosing tenosynovitis, is a condition where a finger gets stuck in a bent position and then snaps straight like a trigger being released. It occurs when inflammation narrows the space within the tendon sheath.¹

Symptoms

• Finger stiffness, especially in morning
• Popping or clicking sensation
• Tender nodule at base of finger
• Finger catching or locking in bent position
• Finger stuck in bent position (severe)
• Most common: ring finger, thumb

Risk Factors²

• Repetitive gripping
• Diabetes (much higher risk)
• Rheumatoid arthritis
• Gout
• Women more affected
• Age 40-60

Grading

• Grade I - Pain, tenderness, no catching
• Grade II - Catching, can actively extend
• Grade III - Locking, needs passive extension
• Grade IV - Fixed flexion contracture

Treatment³

Conservative

• Rest from repetitive gripping
• Splinting at night
• NSAIDs
• Gentle stretching

Corticosteroid Injection

• Very effective first-line treatment
• 70-90% success rate
• May be repeated

Surgery

• A1 pulley release
• Percutaneous or open
• For refractory cases

References

1. Makkouk AH, Oetgen ME, Swigart CR, Dodds SD. Trigger finger: etiology, evaluation, and treatment. Curr Rev Musculoskelet Med. 2008;1(2):92-96.
2. Strom L. Trigger finger in diabetes. J Med Soc N J. 1977;74(11):951-954.
3. Dardas AZ, VandenBerg J, Shen P, et al. Long-term effectiveness of repeat corticosteroid injections for trigger finger. J Hand Surg Am. 2017;42(4):227-235.