Patient information · Orthopaedics
Trigger finger
why it catches, and what fixes it
Trigger finger happens when a tendon in the finger thickens where it passes under a pulley in the palm, so it catches and then releases with a snap. It is uncomfortable, occasionally alarming, and treatable at every stage — and the earlier it is treated, the simpler the treatment.
Arrange prompt assessment if the finger
- is locked and cannot be straightened, even passively
- is red, hot and swollen with fever
- became stuck after an injury or a wound
- has numbness or colour change alongside the catching
- is locked in a child — paediatric trigger thumb is managed differently
A finger locked in a bent position for a long period develops joint stiffness that persists even after the trigger is released, which is why prolonged locking should not be left. Infection in the tendon sheath is a surgical emergency.
What you notice
- Catching or clicking as you bend and straighten the finger, most often the ring finger or thumb.
- Stiffness and locking, characteristically worst first thing in the morning and easing through the day.
- A tender nodule in the palm at the base of the affected finger — the pain is often felt in the finger, but the problem is in the palm.
- In more advanced cases the finger locks bent and has to be straightened with the other hand, or will not straighten at all.
Strongly associated with diabetes
Trigger finger is several times more common in people with diabetes, often affects multiple digits, and responds less well to injection. If you have trigger finger and have not had your blood glucose checked, it is worth doing — it is occasionally the first sign. Also associated are rheumatoid arthritis, an underactive thyroid, gout and Dupuytren's disease.
Treatment, in order
- Activity modification — reduce sustained forceful gripping, and pad tool handles.
- A night splint holding the affected finger straight prevents the morning locking and allows the tendon to settle. Worn for six to twelve weeks it resolves a good proportion of early cases.
- Corticosteroid injection into the tendon sheath is the mainstay and settles a majority of cases, sometimes permanently. A second injection may be given if the first helped but did not last. Success is lower in people with diabetes, and injections can raise blood glucose for a few days.
- Surgical release — a small operation under local anaesthetic dividing the pulley — is highly effective and essentially definitive. It is the right choice for a persistently locked finger, or where injections have failed.
- Hand therapy afterwards to restore full movement, particularly where the finger has been locked for some time.
Self-help
- Gently straighten the finger with the other hand rather than forcing it repeatedly.
- Avoid repeatedly clicking it through, which aggravates the swelling.
- Warmth and gentle range-of-movement exercises in the morning.
- Anti-inflammatory gel over the palm nodule.
- Do not ignore a finger that is spending long periods locked.
Book an appointment if a finger is catching, locking or painful in the palm. We can splint, provide ultrasound-guided injection, check for diabetes, and arrange day-case surgical release without a wait.
Injection and day-case release
Seven days a week, 9am–7pm, on Whitechapel Road.
Tower Bridge Hospital London
97–99 Whitechapel Road, London E1 1DT
WhatsApp 07903 284 189
info@mhwclinic.co.uk
Open Mon–Sat, 9am–7pm (closed Sundays until September)
In an emergency
Call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
When we are closed and it is not an emergency
Call NHS 111 or visit 111.nhs.uk.