Trigger finger or thumb

Trigger finger can be a painful condition, in which a finger or thumb feels stiff, and clicks or locks as it is bent towards the palm. One or more fingers, and/or your thumb can be affected.

It is more common in women over 40 years old. Triggering is more common in people that have insulin dependent diabetes and in people who have rheumatoid arthritis, but also can occur in people without these underlying factors. Another risk factor is Dupuytren’s disease, another hand condition in which the connective tissue in the palm thickens. Repetitive work can also aggravate the condition.

What causes it?

The tendons that bend the fingers, the flexor tendons, run through a series of tight tunnels, or pulleys, which help to hold the tendons in place against the bone when you are gripping.
If a tendon, or the sheath surrounding it (which helps to lubricate the tendon) gets inflamed, the tendon cannot glide easily through the pulleys. This can cause pain, stiffness of the finger, clicking or locking.
You may feel a painful lump on the palm, at the base of the affected finger.
Sometimes your finger may get stuck in a bent position and you may have to help release it.

The exact cause of why this happens is not known.

What are the symptoms?

Pain in the palm of your hand around the base of the affected finger
Tenderness if you press in this area.
A feeling of stiffness, clicking or locking when you are bending and straightening the finger. The finger may lock, and you may need to straighten it manually, using the other hand.
Reduction in movement of the affected finger. In trigger thumb, movement at the tip for example, can be reduced.

What is the treatment?

Trigger finger may get better without any treatment. Try reducing the strain on this joint, and avoid activities that cause pain.

Pain relief

Medication (such as simple painkillers or anti-inflammatories) may be useful. A pharmacist or your GP can help advise you what to take if needed. You can find further information here on what medications you could take here:

How and when to take paracetamol for adults – NHS (www.nhs.uk)

Ibuprofen for adults: painkiller which also treats inflammation – NHS (www.nhs.uk)

Ice or heat therapy

You may find heat helpful to ease stiff and painful joints. Try filling a bowl with warm water or resting your hand on a microwaved heat pack for 10 minutes. Do not use heat if your joint is hot and swollen as it may make it worse. Instead you can consider using an ice pack or bag of frozen peas.

Place a tea towel on your wrist (to protect your skin from ice burns), and then place an ice pack or bag of frozen peas over the painful area. Leave this on for ten minutes and use up to 3 times per day.

Please be cautious using ice if you have altered sensation or circulatory problems.
Check the skin regularly, and stop if there is excessive pain or tingling.

Hand Exercises

General movement of the hand and thumb can be beneficial to maintain range of movement and prevent stiffness.

Splinting

trigger finger or thumb splinter Sometimes wearing a splint at night may help to relieve the symptoms. A hand therapist can fit a splint for you if they feel this will help, or you can source one of these yourself like the one pictured below.

If your symptoms do not resolve, speak to your healthcare practitioner. A hand therapist may be able to help. They can help advise you as to the best management of your trigger finger and provide you with an individual tailored programme. They may make a splint to wear during the day if your symptoms are more severe.

Surgery

A hand therapist or other healthcare practitioner may refer you on for a surgical opinion if your symptoms persist. A steroid injection may be helpful in some cases and some people may require an operation to release the tight tunnel the tendon runs through. You can follow this link for more information on the type of surgery available and when they are indicated here:

Trigger finger/thumb | The British Society for Surgery of the Hand (bssh.ac.uk)