Trigger finger (or trigger thumb) is a condition that causes pain at the base of the finger or thumb, often accompanied by clicking, catching, or locking when the digit is bent.
This typically occurs when moving the finger or thumb towards the palm. In some cases, the finger may become stuck in a bent position and need to be straightened with the other hand, sometimes releasing suddenly with a snap.
The condition most commonly affects the ring finger and thumb, although any finger can be involved.
Symptoms can develop gradually and may include:
- Pain and stiffness when bending the finger or thumb
- Tenderness at the base of the affected digit in the palm
- A small lump or swelling in the palm
- Clicking, snapping, or popping when moving the finger
- Locking of the finger in a bent position
- Difficulty straightening the finger without assistance
In early stages, pain and tenderness are often the main features. As the condition progresses, locking and restriction of movement may become more frequent.
Symptoms can develop gradually and may include:
- Pain and stiffness when bending the finger or thumb
- Tenderness at the base of the affected digit in the palm
- A small lump or swelling in the palm
- Clicking, snapping, or popping when moving the finger
- Locking of the finger in a bent position
- Difficulty straightening the finger without assistance
In early stages, pain and tenderness are often the main features. As the condition progresses, locking and restriction of movement may become more frequent.
Diagnosis is usually made through a detailed clinical history and examination of the hand.
In most cases, no additional tests or imaging are required.
Treatment depends on symptom severity and duration.
Non-surgical treatments may include:
- Rest and activity modification
- Anti-inflammatory medication
- Steroid injection into the tendon sheath
Steroid injections can be effective in up to 70% of cases, particularly when symptoms have been present for less than six months.
However, injections may be less effective in patients with diabetes, cases involving multiple fingers, or where symptoms have been present for a longer period.
In these situations, surgical treatment may be recommended.
If non-surgical treatment is unsuccessful, a minor procedure can be performed to release the tight A1 pulley.
This allows the tendon to glide freely again and resolves the catching or locking.
The procedure is performed under local anaesthetic as a day case and takes approximately 15 minutes to complete. It involves a small incision in the palm near the base of the finger or thumb.
After surgery, a bulky dressing is usually applied for the first 48 hours. This is then replaced with a lighter dressing until stitches are removed at around 10 days.
Recovery timelines vary depending on activity level:
- Office-based work: approximately 2 weeks
- Heavy manual work: up to 6 weeks
Driving is usually possible after 6–7 days, although it is best to wait until stitches have been removed.
Most patients can return to sport within 6 weeks, although more physically demanding activities may require a longer recovery period.
As with any surgical procedure, complications are possible, although uncommon.
These include:
- Infection (around 1%), usually treated with antibiotics. Rarely, deeper infections may require further surgery.
- Swelling and stiffness, which can persist for several months.
- Scar sensitivity in the palm, which typically improves over time and may benefit from massage.
- Nerve injury (rare), which may result in a small area of numbness in the finger.
- Recurrence of symptoms, which may require further treatment.
- Complex Regional Pain Syndrome (CRPS), a very rare condition where the nerves overreact, causing prolonged pain, swelling and sensitivity in the hand. This can take several months to improve.
You should seek medical advice if you experience persistent pain, clicking, or locking in a finger or thumb, particularly if symptoms are affecting daily activities.
Early treatment can prevent progression and reduce the likelihood of needing surgery.
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