Signs and Symptoms
Trigger finger most often affects the ring finger and thumb, but any finger can be involved:
- A tender bump in the palm at the base of the finger or thumb
- Clicking, popping or catching when you bend or straighten the finger
- A finger that locks bent and suddenly snaps straight
- Stiffness that is usually worse in the morning
- In advanced cases, a finger that stays bent and cannot be fully straightened
What Causes It?
The flexor tendons that bend your fingers slide through a series of snug bands called pulleys. When the tendon or the first pulley becomes thickened and inflamed, the tendon can catch as it passes through.
The exact cause is often unclear, but trigger finger is more common in women, in people over 40, and in people with diabetes, rheumatoid arthritis or thyroid disease. Repeated forceful gripping may contribute. People with carpal tunnel syndrome are also more likely to develop trigger finger.
How We Diagnose It at POPB
Trigger finger is diagnosed by examination. Dr. Tucker will look for the tender nodule in your palm and watch as you open and close your hand to see the catching.
Imaging is usually not needed. X-rays or diagnostic ultrasound, both available in our office, may be used if arthritis, a cyst or another problem is suspected.
Non-Surgical Treatment Options
Many people improve without surgery, especially when treatment starts early:
- Rest from forceful or repetitive gripping
- A splint that holds the affected finger straight, often at night, custom-fit by Elise Burger, OTR, our occupational and hand therapist
- Hand therapy with Elise Burger for gentle tendon gliding exercises and advice on grip and tool use
- A cortisone injection into the tendon sheath, which relieves symptoms for many patients. A second injection may be considered if symptoms return, though people with diabetes may respond less well.
Surgical Options
If triggering continues after injection and splinting, or if the finger is locked, Dr. Tucker may recommend trigger finger release. Through a small incision in the palm, she releases the tight pulley so the tendon can glide freely.
The procedure is typically done on an outpatient basis with local anesthesia, and you go home the same day.
Recovery
After a cortisone injection, relief often begins within days to a few weeks. After trigger finger release, you can usually move the finger right away and use the hand for light tasks within a few days. Soreness and some stiffness at the incision can last several weeks, and full recovery often takes a few months. Timelines vary.
If stiffness persists, hand therapy with Elise Burger in our office can help restore motion, and she coordinates closely with Dr. Tucker.
Insurance and Cost
Office visits, splints, hand therapy, cortisone injections and medically necessary surgery are generally covered by Medicare, most commercial PPO plans and workers' compensation, subject to your deductible and co-pay.
HMO and managed-care plans require a referral from your primary care physician to be in our office before your visit. Our staff verify your eligibility and benefits when you call.
When to Be Seen
Make an appointment if a finger catches, clicks or locks, or if you have a painful bump at the base of a finger. See a physician promptly if a finger is stuck bent and you cannot straighten it. If a finger is red, hot and swollen, or you have a fever, seek care the same day, since that can be a sign of infection.
