Trigger Finger or Thumb

This leaflet provides general information about trigger finger or thumb, including the treatment options available for those suffering.

What is Trigger Finger or Thumb?

Trigger finger or thumb refers to the catching or locking of a finger or thumb as it bends and straightens. Whilst not a serious or life-threatening condition, it can cause pain at the base of the affected digit and interfere with normal hand function.

What Causes Trigger Finger or Thumb?

Trigger finger occurs due to thickening around the tendon responsible for bending your finger or thumb. This thickening can create a nodule, causing the tendon to catch or lock as it moves.

Trigger finger can develop in any digit, though it is more common in the thumb, middle, or ring fingers. It can affect people of any age, from infants to the elderly, and occurs in both men and women. Certain conditions, such as diabetes or rheumatoid arthritis, can increase the likelihood of developing trigger finger, or make symptoms more severe.

How is it Diagnosed?

Trigger finger/thumb is usually diagnosed by a doctor or hand therapist. They will examine your hand, focusing on any thickened or tender areas, and observe signs of locking or clicking.

What Are the Symptoms?

• A clicking or catching sensation in the affected finger or thumb.
• Difficulty straightening the finger without using your other hand.
• Pain or tenderness at the base of the affected digit.
• In severe cases, the finger may become stuck in a bent position.

Do I Need Treatment?

Mild symptoms often resolve on their own and may not require treatment. However, treatment is recommended if:

• Your finger locks frequently, affecting your hand function.
• Your finger becomes stuck in a bent position.
• The condition causes significant pain.

What Are the Treatment Options?

Treatment options depend on the severity of your symptoms and include:

Anti-inflammatory Medications

• Over-the-counter anti-inflammatory tablets or gels can help alleviate symptoms

Splinting

• A night splint can keep the finger straight, preventing locking and reducing strain on the tendon but is rarely a cure.

Steroid Injections

• A local steroid injection into the affected area can provide relief for up to 80% of patients. Results may be noticeable within days but could take weeks. A second injection may be helpful if symptoms persist.

Surgery

• Surgery may be necessary if other treatments are ineffective or if symptoms are severe.

What Does Surgery Involve?

Surgery is usually a day case performed under local anaesthetic. During the procedure:

• The surgeon makes a small incision in the palm.
• The thickened tissue causing the trigger finger is released to restore smooth tendon movement.

Pre-Operative Preparation

Key Points:

• Smoking Cessation: Quitting smoking before surgery reduces the risk of complications and promotes better healing.
• Please remember to remove all rings from your fingers before arriving at the hospital.

What to Expect After Surgery

• Discomfort: Mild discomfort is normal, and can be managed with over-the-counter painkillers.
• Elevation: Keep your hand elevated to reduce swelling during the first 48 hours post surgery.
• Bandages: The bulky bandage can be removed after 48 hours, leaving a smaller sticky dressing. Avoid wetting the dressing until fully healed.

Post-Surgery Care

• Move your fingers gently to prevent stiffness.
• Avoid pressure on the surgical site.
• Your wound should heal within 10–14 days.

Risks and Possible Complications

While complications are uncommon, they may include:

• Delayed Wound Healing or Infection: Signs include increased pain, redness, swelling, or discharge. Seek medical attention if these occur.
• Scar Tenderness: This may last for a few months and can be treated with regular scar massage or therapy if needed.
• Stiffness: Temporary stiffness is common, but should resolve within a few months. Seek advice if stiffness persists.
• Nerve Damage: This could cause numbness or a painful spot in the scar.
• Chronic Regional Pain Syndrome (CRPS): A rare complication causing swelling, pain, and stiffness. Therapy may be needed to manage this.

Follow-Up Appointments

• A follow-up appointment may not be necessary unless your consultant advises otherwise.

Returning to Work

The timing depends on your job:

• Desk-based jobs: Return within a few days.
• Light manual work: 1–2 weeks off.
• Heavy manual work: Several weeks off.

Discuss this with your surgeon.

Smoking Cessation

Quitting smoking before surgery reduces the risk of complications and promotes better healing.

Please remember to remove all rings from your fingers before arriving at the hospital.