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What is Trigger Finger or Stenosing Tenosynovitis?


Stenosing tenosynovitis (stuh-NO-sing ten-o-sin-o-VIE-tis), commonly known as “trigger finger” or “trigger thumb”, involves the pulleys and tendons in the hand that bend the fingers. One of your fingers or your thumb gets stuck in a bent position and then straightens with a snap — like a trigger being pulled and released. If trigger finger is severe, your finger may become locked in a bent position.

What causes trigger finger/stenosing tenosynovitis? 


Causes for this condition are not always clear. Some trigger fingers are associated with medical conditions such as rheumatoid arthritis, gout, and diabetes. Local trauma to the palm/base of the finger may be a factor on occasion, but in most cases there is not a clear cause. Often painful, trigger finger is caused by a narrowing of the sheath that surrounds the tendon in the affected finger. People whose work or hobbies require repetitive gripping actions are more susceptible. Trigger finger is also more common in women and in anyone with diabetes.

Treatment of trigger finger varies depending on the severity.

Signs and symptoms of trigger finger may progress from mild to severe and include:

  • Finger stiffness, particularly in the morning
  • A popping or clicking sensation as you move your finger
  • Tenderness or a bump (nodule) at the base of the affected finger
  • Finger catching or locking in a bent position, which suddenly pops straight
  • Finger locked in a bent position, which you are unable to straighten

Trigger finger more commonly occurs in your dominant hand, and most often affects your thumb or your middle or ring finger. More than one finger may be affected at a time, and both hands might be involved. Triggering is usually more pronounced in the morning, while firmly grasping an object or when straightening your finger.

When to see a doctor:

If you have any stiffness or catching in a finger joint, bring it to the attention of your doctor so that he or she may review your symptoms and perform a physical evaluation of your hand. If your finger joint is hot and inflamed, seek immediate medical care because these signs indicate a possible infection.

The goal of treatment in trigger finger/thumb:

  • Allow full movement of the finger or thumb
  • Reduce swelling around the flexor tendon
  • Wearing of a splint or taking anti-inflammatory medication
  • Change of activities
  • Steroid injection in the area around the tendon torelieve the trigger finger/thumb

If non-surgical forms of treatment do not relieve the symptoms, surgery may be recommended. This surgery is performed as an outpatient, usually with simple local anesthesia. The goal of surgery is to open the pulley at the base of the finger so that the tendon can glide more freely. Active motion of the finger generally begins immediately after surgery. Normal use of the hand can usually be resumed once comfort permits.