Home / Conditions / Trigger finger
A finger or thumb catches, clicks or locks as it bends and straightens, often with a tender lump at its base in the palm. The tendon that bends the finger has thickened and catches in the tunnel it runs through. It is more common with diabetes, in women and after 40, and most cases are settled by a splint or an injection, with a small operation for the rest.
Trigger finger tends to move through stages. Where you are decides what is most likely to help, and a finger that has only just started to catch often needs the least.
| Stiff and sore | Clicks or catches | Locks | |
|---|---|---|---|
| What you notice | A sore, tender lump at the base of the finger or thumb; stiff in the morning | A click or catch as the finger bends or straightens | The finger sticks bent, or has to be pushed straight with the other hand |
| What usually helps | Less gripping, and a splint at night | A steroid injection | An injection, or a release operation |
Not every bent or lumpy finger is trigger finger. A finger slowly pulled bent over months, with a firm cord in the palm and no clicking, is usually a different condition; a small, pea-sized lump at the base of a finger can be a ganglion; and a finger that cannot straighten at its tip after a knock may be mallet finger.
A finger that is hot, red and swollen, and hurts to straighten, is not trigger finger. It may be an infection inside the tendon sheath and needs seeing the same day: call the clinic and come in, or go to an emergency department if we are closed. See swollen finger.
The tendons that bend each finger run along the palm side, held close to the bone by a series of tight bands, like the rings that hold a fishing line to its rod. The first band, at the base of the finger in the palm, is where trigger finger happens.
What a picture cannot show is how the click happens. It is often put down to inflammation, but the tendon and its band have mostly thickened with repeated use, so a small lump on the tendon catches at the band's edge, then snaps through — and if it cannot get through at all, the finger locks.
It also explains the treatments. An injection shrinks the thickening so the tendon glides again; a release operation divides the tight band so there is nothing left for the tendon to catch on.
Treatment steps up from a splint to an injection to a small operation. Most fingers are settled by the first two.
For a finger that is sore or only just starting to catch, less gripping and a splint that holds the finger straight at night for a few weeks can be enough.
An injection into the tendon sheath settles many trigger fingers, often after a single dose, and it can be repeated once. It works less well in diabetes, and can raise blood sugar for a few days.
A short operation under local anaesthetic divides the tight band at the base of the finger. Light use of the hand is usually possible within days, with full recovery over a few weeks, and the problem rarely returns.
In toddlers, a thumb stuck bent often straightens on its own over the first few years. A release is considered if it does not.
Trigger finger here is seen by Dr Palanisamy Arul Murugan, an orthopaedic surgeon whose practice covers the hand and wrist, and who treats the full range of hand conditions with both non-surgical and surgical techniques. He holds the MRCS (Edinburgh), a Master of Medicine and the FRCS in orthopaedics, and consults in English, and in Tamil or Hindi if preferred.
Sometimes, if it is mild and caught early, especially with less gripping and a splint. Many cases carry on or get worse without treatment, though, and a locked finger rarely frees up by itself.
Often, yes. Many fingers settle after a single injection, and it can be repeated once. It works less well in people with diabetes, where a release operation is more often needed.
A short operation under local anaesthetic, through a small cut in the palm, to divide the tight band the tendon catches on. You go home the same day, can use the hand lightly within days, and recover fully over a few weeks.
After a night of not moving, the thickened tendon is stiffer and catches more easily. It usually loosens up as you use the hand during the day.
Yes, most often as a trigger thumb in young children, where the thumb stays bent at its tip. It often straightens on its own over the first few years, and a release is considered if it does not.
No. Be ready to say which fingers are affected, how long it has been happening, and whether you have diabetes.
Swollen finger · Ganglion cysts · Hand arthritis · Carpal tunnel syndrome · Mallet finger
Tell us which fingers are affected and whether they lock. It decides which step of treatment to start with.
