It starts innocently enough.
You bend your finger and it clicks.
A few days later, it catches again.
Then one morning you try to straighten it and it seems to get stuck. You give it a little pull and suddenly — click — it snaps straight.
That is where the name trigger finger comes from.
It is a surprisingly common problem, and although it can be uncomfortable and irritating, it is usually treatable.
What exactly is trigger finger?
To understand it, you need to know a little about how your fingers work.
Muscles in your forearm control the fingers through long, strong cords called tendons. These tendons run through small tunnels and pulleys in the hand, allowing them to glide smoothly as you bend and straighten your fingers.
With trigger finger, the tendon or the surrounding sheath becomes swollen or thickened.
Instead of gliding smoothly, the tendon catches as it passes through the narrowed area.
That produces the characteristic clicking, catching or locking.
It is rather like trying to pull a slightly thick piece of string through a hole that is just a little too small.
What does it actually feel like?
People describe it in different ways.
You may notice soreness at the base of the affected finger, particularly on the palm side of the hand.
The finger may feel stiff when you first wake up.
Then comes the clicking.
You bend the finger and it catches. Sometimes you can straighten it normally; sometimes you have to use your other hand to straighten it.
In more advanced cases, the finger can become stuck in a bent position.
The thumb can also be affected, and this is commonly called trigger thumb.
Usually only one or two fingers are involved, although more than one can certainly develop the problem.
Why does it happen?
Sometimes, frankly, we don’t know.
Trigger finger is more common in adults, particularly as we get older.
Certain conditions increase the likelihood, including diabetes and rheumatoid arthritis.
Repeated gripping or activities that place a lot of strain on the hands may also contribute in some people.
But don’t assume that because you use a computer, garden, play golf or spend time doing DIY, you have somehow caused it.
Often there isn’t one obvious culprit.
Is it arthritis?
Not necessarily.
This is a common misunderstanding.
Arthritis affects the joints.
Trigger finger is primarily a problem involving the tendon and the tissue surrounding it.
That said, someone can have arthritis and trigger finger at the same time.
Can it get better by itself?
Yes, sometimes.
Mild cases may settle without invasive treatment, particularly if the irritation is relatively recent.
But if the finger is repeatedly catching or locking, I wouldn’t recommend simply putting up with it indefinitely.
The longer it becomes troublesome, the more it can interfere with everyday activities.
Something as simple as opening a jar, holding a cup, writing or gripping a steering wheel can become surprisingly uncomfortable.
What can you do yourself?
If the problem is mild, giving the hand a little rest from activities that repeatedly aggravate it can help.
Some people find that keeping the finger from repeatedly bending during sleep is useful. A pharmacist or healthcare professional can advise about an appropriate splint.
Simple pain relief such as paracetamol can help if there is discomfort.
Anti-inflammatory medicines or gels may also help with pain for some people, provided they are suitable for the individual.
But there is an important distinction here.
Pain relief doesn’t necessarily fix the catching.
The problem is mechanical — the tendon isn’t gliding freely through the narrowed area.
So if the finger continues to lock despite painkillers, it needs proper assessment.
What will the doctor do?
Usually the diagnosis is made simply by listening to the symptoms and examining the hand.
You don’t normally need an X-ray to diagnose straightforward trigger finger.
If the symptoms are troublesome, a doctor may recommend a steroid injection.
The injection is given around the affected tendon sheath to reduce the inflammation and swelling.
For many people, this can work very well.
It isn’t guaranteed to be permanent, however, and some people may experience the problem again.
What if the injection doesn’t work?
If trigger finger remains severe or keeps coming back, a small surgical procedure may be considered.
The operation releases the tight area around the tendon so that it can move freely again.
It is generally a relatively straightforward procedure, and the prognosis is usually good.
Most people regain normal movement once the tendon is able to glide properly again.
When should you get it checked?
I’d suggest getting it assessed if:
- The finger repeatedly locks or catches
- You are having difficulty straightening it
- The pain is getting worse
- It is interfering with normal activities
- The finger becomes permanently stuck in a bent position
I’d be particularly keen for someone with diabetes to have persistent symptoms assessed rather than simply ignoring them.
And one final point…
If you have a finger that occasionally clicks, don’t immediately assume you’re heading for surgery.
Many cases are mild and manageable.
But if that occasional click turns into repeated catching and eventually your finger starts behaving like a badly made folding knife, it’s time to get it looked at.
Trigger finger is annoying, but it is also one of those conditions where the right treatment can make a remarkable difference.
And unlike some of the aches and pains we acquire with age, there is often something we can actually do about it.
Until next time, look after those hands. You’ll miss them the moment they stop cooperating.
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