What is trigger finger: symptoms and diagnosis
Getting that annoying clicking or locking sensation in your finger or thumb? Pain in your finger or thumb when you use it too
much? It could be a trigger finger or thumb. Don’t worry, there are solutions. I offer a range of treatments, including injections in clinic and I’m one of the first surgeons in the UK currently performing an ultra-minimally invasive ultrasound-guided technique that can get you back to doing the things you love even more quickly than traditional techniques. Let’s talk about how to get those fingers moving smoothly again.
Ali Phillips | Hand & Wrist Specialist
Why does my finger keep getting stuck?
I'm Ali Phillips. It’s a frustrating feeling when your finger catches, clicks, or locks. This guide will help you understand why it's happening and learn about a modern, 'keyhole' treatment that can fix it simply and quickly.
Book a ConsultationWhat is Trigger Finger?
Think of the tendons that bend your fingers as lines of rope running through a series of tight pulleys that hold them to the bone. Trigger finger happens when the first pulley at the base of your finger (the A1 pulley) becomes too thick and tight.
The tendon can no longer glide smoothly through it. It catches, and then with more force, it pops through with a painful click or snap. The more it rubs, the thicker the tendon gets, and the more it gets stuck. It is a true vicious cycle!
The aim of treatment is to stop it rubbing, which stops the pain and breaks the cycle.
What are the symptoms of Trigger Finger?
Painful Clicking or Popping
A distinct and often painful clicking, snapping, or popping sensation when you bend or straighten your finger.
Finger Locking or Stuck
The finger gets stuck in a bent position and you might have to use your other hand to gently straighten it out.
Tender Lump in Palm
You may feel a small, tender lump in your palm at the base of the affected finger, which is the inflamed pulley.
Is Your Finger Getting Stuck?
If these symptoms sound familiar, you don't have to just live with the frustration. An accurate diagnosis is the first step towards smooth, pain-free movement. Let's talk about your options.
Find Out Your OptionsDoes this sound like you?
Jane's Story: The Avid Crafter
Jane loves knitting, but her hobby became a source of frustration when her index finger started locking painfully. She was worried about needing surgery. We decided to try a steroid injection first, which can often be a permanent cure. The injection provided complete relief, and the triggering never came back, allowing her to continue her passion for knitting without any further issues.
John's Story: The Passionate Golfer
John, a 62-year-old golfer, found his ring finger kept locking every time he gripped his club, ruining his game. He’d had an injection which worked for a while, but the problem came back. We performed an ultrasound-guided release in the clinic, which took about five minutes. He went home with a small plaster, was chipping in his garden the next day, and back playing a full 18 holes within the week. He told me it was "like magic".
How will I diagnose your finger?
Getting the right diagnosis is simple and quick. When you see me, I can usually diagnose trigger finger just by listening to your story and examining your hand. No complex scans are needed.
1️⃣
Listening to You: I'll ask you to describe the clicking, locking, and any pain you're experiencing.
2️⃣
A Gentle Examination: I will feel for the tender lump in your palm and ask you to bend and straighten your finger to see and feel the triggering myself.
3️⃣
Instant Confirmation with Ultrasound: I can use my ultrasound scanner right there in the clinic. This confirms the diagnosis instantly and lets us both see the problem on the screen, which is very reassuring.
The diagnosis is usually obvious from the classic locking symptom and the tender lump in your palm. It's a very straightforward process to confirm what's going on.
Tired of the Clicking and Locking?
If your finger is getting stuck and causing you pain, it's time to get it sorted. A simple consultation can provide a clear diagnosis and a path to a permanent solution.
Book Your AppointmentHow can I help you get better?
The goal of any treatment is to get that tendon gliding freely again. We'll create a treatment plan together, starting with the simplest options.
Rest & Activity Modification Sometimes, simply resting the hand and avoiding activities that cause the triggering can allow the inflammation to settle down.
Splinting Wearing a splint, especially at night, can help by preventing your finger from locking while you sleep, which can reduce morning stiffness and pain.
Steroid Injections An injection of corticosteroid medication directly into the tight tunnel is a very effective way to reduce swelling and can cure the problem in many patients.
If an injection hasn't worked or the symptoms return, a minor procedure is the logical next step to fix the problem for good.
What is Ultrasound-Guided 'Keyhole' Release?
This is a state-of-the-art 'keyhole' procedure. Instead of an open cut, I make a tiny 1-2 millimetre incision. Using a real-time ultrasound scanner to see inside your hand, I guide a special instrument to precisely divide the tight pulley. The tiny entry point doesn't even need a stitch, just a small plaster, and the procedure takes about five minutes in the clinic.
Benefits
- Permanent solution
- Extremely high success rate (over 99%)
- Minimally invasive (1-2mm incision)
- Much faster recovery than open surgery
Small Risks
- Infection (about 1 in 20 cases)
- Stiffness or continued locking (about 1 in 18 cases)
- Need for further surgery (very rare, about 1 in 200 cases)
- Painful scar (uncommon with this technique)
The decision to have a procedure is one we make together. I will ensure all your questions are answered so you feel confident in our plan.
Understanding Consent for Surgery
If we decide a procedure is the right path, it is imperative that you understand the process, the risks, and your rights. This is a partnership, and your informed consent is the most important part.
You have every right to choose not to have a procedure. You may choose to continue with non-surgical treatments like injections or splinting, or decide on no treatment at this time. The decision is always yours.
It is critical to appreciate that any procedure has risks. The decision to go ahead is a fine balance between the potential benefits and these risks.
The only person who can judge that balance is you. My role is to give you the clearest possible information so you can make the choice that is right for you.
This is a very safe procedure, and complications are rare. Using ultrasound guidance reduces the risks even further. However, it's important you are aware of them:
- Infection: In about 1 in 20 people, there might be signs of infection like redness or warmth. This can almost always be treated with simple care and sometimes antibiotics.
- Stiffness or Continued Locking: About 1 in 18 people might feel their finger is still a bit stiff or occasionally locks after the procedure. This usually improves with time and exercises.
- Need for Further Surgery: Very rarely (about 1 in 200 people), another procedure might be needed to get things just right.
- Tendon Rupture: This is an extremely uncommon complication that I have never seen in my practice, but it is a theoretical risk.
Your Personalised Corner ✨
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Gentle Exercise Helper
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Frequently Asked Questions
In some mild cases, it can improve with rest. However, if it's causing significant pain or locking, it's best to seek treatment as it often doesn't resolve on its own and can become more persistent.
A steroid injection is a powerful anti-inflammatory medication delivered right to the problem area. It reduces the swelling in the tight tunnel, which helps the tendon to glide more smoothly again and can often cure the problem.
Recovery is very fast. Most people can return to light activities like typing or gripping a cup the next day. More strenuous activities can often be resumed within a week. You'll just have a small plaster over the tiny incision.
While you might get trigger finger in more than one finger, the condition doesn't spread from one finger to another. There might be an underlying reason, like a medical condition, making you more prone to developing it in multiple fingers.
Yes, it's true that people with diabetes might be at a slightly higher risk for developing trigger finger. While we might not be able to change that, we can absolutely work together to manage the condition and find ways to reduce discomfort.
Test Your Knowledge!
Faqs
Trigger finger, also known as stenosing tenosynovitis, occurs when the bending (flexor) tendon in your finger becomes inflamed and thickened. You can feel this as a nodule in your palm, at the base of the finger, that moves as you bend your fingers. The thickening / nodule can make it difficult for the tendon to glide smoothly through its sheath, causing the finger to get stuck in a bent position. Several factors can contribute to trigger finger, including:
- Repetitive hand movements: Activities that involve repeated gripping or grasping can strain the flexor tendon and increase the risk of trigger finger.
- Certain medical conditions: Diabetes, rheumatoid arthritis and gout are associated with a higher incidence of trigger finger.
- Hand or wrist injuries: Trauma to the hand or wrist can damage the tendon sheath or create scar tissue, leading to inflammation and trigger finger.
- Gender and age: Women and individuals over 40 are more prone to developing trigger finger.
While trigger finger is not technically a form of arthritis, it shares some similarities with inflammatory arthritis conditions. Both involve inflammation in the joints and tendons, causing pain and stiffness. However, trigger finger is primarily a problem with the tendon sheath, while arthritis affects the joints themselves.
Yes, there is a well-established link between trigger finger and diabetes. People with diabetes are more likely to develop trigger finger than those without the condition. The exact reason for this association is not fully understood, but it is thought that high blood sugar levels may contribute to tendon inflammation and stiffness.
Trigger finger release surgery is a relatively quick procedure, typically taking 10-20 minutes per finger. It is performed under local anaesthesia as an outpatient procedure. I do these using ultrasound guidance and the incision is 1mm and no stitches are required.
Trigger finger surgery is done under local anaesthesia, which numbs the area in the palm at the base of the fingers, to prevent pain during the procedure. You will not feel any pain during the procedure.
Yes, it is possible to have carpal tunnel and trigger finger surgery performed at the same time. Both procedures are relatively minor and can be done under local anaesthesia. Combining the surgeries can save time and reduce the overall recovery period. I do both of these procedures under ultrasound guidance through tiny incisions for even faster recovery
Recovery time from trigger finger surgery varies depending on the individual and the extent of the procedure. Most people can expect to resume light activities within a few days and return to work within a week. Full recovery, including regaining full strength and flexibility in the finger, may take several weeks.
The cost of trigger finger surgery in the UK can vary depending on the hospital or clinic. The cost for a single finger trigger finger release surgery is around £2240 without insurance. It is important that you get a quote for your procedure as the cost can vary depending on where and how it is done.
Steroid injections can provide significant relief from trigger finger symptoms within a few days to a few weeks. The effects are usually temporary, lasting several months to a year. However, in some cases, a single injection may be curative.
After surgery, you can expect some swelling, bruising and discomfort in the affected finger. I will provide you with instructions on how to care for your hand and finger after surgery. This may include taking pain killers and doing hand exercises. The vast majority of the time you will not need any therapy after surgery. If you are struggling, I will ask my expert hand therapy colleagues to help with specific exercises. These exercises may include gentle stretching, range of motion exercises and strengthening exercises.
