Trigger Finger

What is a trigger finger?

A trigger finger is an overuse injury that affects the muscle tendon which bends the finger (flexor tendon). Finger flexor tendons pass through bands of tissue called “pulleys” which hold the tendons close to the finger bones. Inflammation of finger flexor tendons can occur after repetitive or strenuous use of the hand, which causes pain and swelling over the tendons and pulleys. This makes it difficult for the tendons to glide through the pulleys smoothly. A catch (“trigger”) of the finger thus occurs when trying to straighten it from a bent position.

Trigger finger often occurs over time from frequent, repetitive and/or forceful use of our hands in daily activities (e.g. frequent wringing of cleaning cloths/mops when doing housework, cooking/ baking, assembly line work, technical work that requires frequent use of hand tools, life events such as moving house). Finger tendons may become strained over time, resulting in inflammation of the tendon and pulley.

How do I know if I have a trigger finger?

Signs and symptoms of a trigger finger may include:

• A lump or swelling at the base of the finger/ thumb on the palm side of the hand which may be painful or tender when there is pressure on it.
• During finger/ thumb movements, the finger/thumb becomes stuck in a bent position and force is required to straighten it out. This may result in a “clicking” or “popping” sensation when opening up your finger/ thumb, which may also be accompanied by pain.
• Feelings of stiffness and loss of mobility over the affected finger/ thumb (especially upon waking up in the mornings).

How is a trigger finger diagnosed?

Your specialist Doctor will obtain your health history and perform a physical examination. Radiological investigations (e.g. X-rays, CT scans) are usually not needed.

How is a trigger finger treated?

It is important to seek early treatment for a trigger finger as success rates tend to decrease as more time passes by before the start of treatment. Treatment for trigger finger includes both non-surgical and surgical options. Non-surgical treatment options (such as Hand Therapy and medications) are usually effective for trigger finger cases that are mild to moderate in severity, while severe cases of trigger finger will likely require surgical interventions.

Hand Therapy

Trigger finger cases that are mild to moderate in severity often respond well to Hand Therapy.

Treatment may include but is not limited to:

• Advice and education pertaining to your condition
• Wax therapy
• Ultrasound therapy
• Advice on lifestyle and activity modifications so as to eliminate or minimise daily activities or finger/thumb movements which may further aggravate the condition
• Provide a customised splint to be worn over the affected finger/ thumb when you are using your hands to perform daily activities so as to provide support and encourage further rest of the finger/ thumb
• Soft tissue mobilisation and release
• Appropriate and personalised exercises to improve finger joint and muscle movements while avoiding aggravation of trigger finger symptoms
• Pain relief/ management

Non-surgical Treatment

Your Doctor may suggest other non-surgical interventions such as anti-inflammatory medications, or corticosteroid injections over the site of inflammation which can also help reduce inflammation, pain and triggering over the involved finger/thumb.

Surgical Treatment

If trigger finger symptoms are severe or do not improve over time with non-surgical interventions, your Doctor may recommend a trigger finger release surgery. Hand therapy is often required after surgery to help regain the movement, strength and function of the affected finger/ thumb.