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Trigger Finger

    Trigger Finger

    TRIGGER FINGER is a common cause of FINGER PAIN.   Many times the affected finger(s) also catch or click with motion.  Symptoms are often worst in the morning and may begin as morning STIFFNESS.  Trigger finger is very commonly associated with DIABETES but is also very common in non-diabetics.  While most common in older adults it can present in CHILDREN.  Treatment options include splinting, anti-inflamatories, cortisone injections or surgery.

    What is it?

    Trigger finger is caused initially by thickening of the first pulley holding the tendon in place.  (see diagram).  This then causes secondary inflammation and swelling of the tendon.  It is this thickening that causes the characteristic snapping of the finger as it moves back and forth.  Trigger finger is often associated with diabetes but is also associated with aging, obesity, forceful repetitive activity as well as other factors.


     Finger-(1).jpgFinger2.jpg

    Figure 2: Abnormal anatomy & showing tendon catching thick,tight pully. Sometimes the tendon will be locally enlarged and thicker.

    © 2006 American Society for Surgery of the Hand. Developed by the ASSH Public Education Committee.

    Treatment choices.

    Options for treatment include splinting and oral anti-inflammatory medications (NSAIDS) although these are often ineffective.  Injections of steroid medications (such as depo-medrol) into the tendon sheath are curative about 60% of the time and generally produce 3 to 6 months of symptom relief in the other 40% of patients.   Surgical release of the pulley is highly effective and is usually performed as a local anesthetic procedure.  Many patients recover very quickly but some have residual pain, swelling and/or stiffness for several months.  Trigger digit does not generally resolve without treatment.