What are the symptoms of Trigger Finger (Stenosing Tenosynovitis)?

Common symptoms include: Finger stiffness, particularly in the morning; Clicking, popping, or snapping sensation when moving the finger; Tenderness or bump (nodule) at the base of the finger in the palm; Finger catching or locking in a bent position; Finger may suddenly pop straight when force is applied.

How is Trigger Finger (Stenosing Tenosynovitis) diagnosed?

Diagnosis typically involves: Medical history focusing on symptoms, occupation, and other hand conditions; Physical examination of the hand and affected digit; Palpation for nodule or tenderness over the A1 pulley; Assessment of triggering, catching, or locking during finger movement.

What are the treatment options for Trigger Finger (Stenosing Tenosynovitis)?

Treatment options range from conservative measures to surgical interventions, including: Rest and activity modification to reduce repetitive gripping; Splinting, particularly at night, to keep the finger extended; NSAIDs for pain and inflammation; Corticosteroid injection into the tendon sheath (often effective); A second injection may be offered if the first provides partial relief.

Trigger Finger (Stenosing Tenosynovitis)

Also known as: Trigger finger, Trigger thumb, Stenosing tenosynovitis, Stenosing flexor tenosynovitis, Flexor tendon sheath stenosis, Locking finger, Snapping finger

Last updated: December 18, 2024

Trigger Finger (stenosing tenosynovitis) is a condition in which a finger or thumb can get stuck in a bent position and may straighten with a snap. It happens when the tendon sheath around the flexor tendon becomes inflamed and constricted, limiting smooth movement. Common signs include morning stiffness and clicking or popping with motion. Many cases improve with conservative treatment or a corticosteroid injection.

Key Facts

•Trigger finger, medically known as stenosing tenosynovitis, is a condition where a finger or thumb gets stuck in a bent position and straighten with a snap, like a trigger being pulled and released
•Finger stiffness, particularly in the morning
•Diagnosed through history, physical exam, and imaging
•First-line treatment includes exercise, weight management, and activity modification

What It Is

Trigger finger, medically known as stenosing tenosynovitis, is a condition where a finger or thumb gets stuck in a bent position and may straighten with a snap, like a trigger being pulled and released. It occurs when the tendon sheath that surrounds the flexor tendon becomes inflamed and constricted, preventing smooth tendon gliding.

Affected Anatomy

This condition affects several structures in and around the joint:

•Flexor tendon of the affected digit
•A1 pulley (the structure where triggering typically occurs)
•Tendon sheath (synovium surrounding the tendon)
•Metacarpophalangeal (MCP) joint area at the base of the finger
•Any finger can be affected, though ring finger and thumb are most common

Common Symptoms

Symptoms can vary in intensity and may change over time. Common experiences include:

•Finger stiffness, particularly in the morning
•Clicking, popping, or snapping sensation when moving the finger
•Tenderness or bump (nodule) at the base of the finger in the palm
•Finger catching or locking in a bent position
•Finger may suddenly pop straight when force is applied
•In severe cases, the finger may become locked and unable to straighten
•Pain when bending or straightening the finger
•Symptoms often worse in the morning or after periods of inactivity

Causes and Risk Factors

Multiple factors can contribute to the development of this condition:

Causes

•Repetitive gripping or grasping motions
•Inflammation and thickening of the A1 pulley
•Nodule formation on the flexor tendon
•Tendon swelling from overuse or inflammatory conditions
•Exact cause is often unclear in many cases

Risk Factors

•Female sex (more common in women)
•Age between 40 and 60 years
•Diabetes mellitus
•Rheumatoid arthritis or other inflammatory conditions
•Occupations or hobbies involving repetitive gripping
•Carpal tunnel syndrome (may coexist)
•De Quervain tenosynovitis (may coexist)
•History of hand surgery, particularly for carpal tunnel

How It's Diagnosed

Diagnosis typically involves a combination of clinical assessment and imaging studies:

•Medical history focusing on symptoms, occupation, and other hand conditions
•Physical examination of the hand and affected digit
•Palpation for nodule or tenderness over the A1 pulley
•Assessment of triggering, catching, or locking during finger movement
•Evaluation for coexisting hand conditions
•Imaging studies are generally not required for diagnosis
•Differential diagnosis excludes joint or other tendon problems

Treatment Options

Treatment approaches range from conservative measures to surgical interventions, often starting with the least invasive options:

Self-Care and Activity Modification

•Rest and activity modification to reduce repetitive gripping
•Splinting, particularly at night, to keep the finger extended

Physical Therapy and Exercise

•Physical or occupational therapy for stretching and exercises

Medications

•NSAIDs for pain and inflammation

Injections and Office-Based Procedures

•Corticosteroid injection into the tendon sheath (often effective)
•A second injection may be offered if the first provides partial relief

Surgery

•Trigger finger release surgery if conservative measures fail

Prognosis and Recovery

The course of this condition varies between individuals:

•Many cases resolve with conservative treatment or corticosteroid injection
•Corticosteroid injections may provide lasting relief in many patients
•Response to injection may be lower in patients with diabetes
•Surgical release typically provides lasting resolution of symptoms
•Recurrence after successful treatment is possible but uncommon

Trigger Finger Release Surgery(Procedure)
De Quervain Tenosynovitis(Condition)