Trigger Finger Info
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Trigger finger causes painful catching or locking of a finger, often treated with splinting or steroid injection.
What you're feeling
You may feel pain and tenderness in the bottom of your palm, right where your finger meets your hand. Sometimes this pain travels to the back of your knuckle or the middle joint of your finger. You might notice a small lump or knot in your palm. This lump is a thickened area where the tendon moves. Many people feel this problem is in their middle joint, even though the issue starts lower down.
The most common sign is catching or locking of your finger or thumb. You might feel a snap when you bend your hand, especially after gripping something tightly. This snapping is often worse in the morning. In severe cases, your finger gets stuck in a bent position. You may need to use your other hand to force it straight. If you have diabetes, this condition is more likely to affect multiple fingers.
Daily tasks can become difficult when your finger locks. Reaching behind your back to fasten a bra or tucking in a shirt may be hard. You might struggle to grip objects firmly or let go of them smoothly. If you have rheumatoid arthritis, several fingers could be involved. While the pain is real, the locking and catching are usually the main reasons you seek help.
What's actually happening
Your finger moves because a strong rope-like tendon slides through a tight tunnel in your palm. This tunnel is held in place by a band called the A1 pulley. In trigger finger, this tunnel becomes too narrow or the tendon develops a small lump. Think of it like a frayed shoelace trying to pass through a tight eyelet. The tendon gets stuck, causing that snapping or locking feeling you notice, especially in the morning.
This lump is often called Notta's nodule. It forms where the tendon meets the pulley, usually just at the base of your finger. When you try to bend your finger, this swollen area catches on the tight band. In severe cases, your finger locks in a bent position and you must use your other hand to force it straight. This happens because the tendon cannot slide smoothly through the narrowed space.
The condition is more common in women over 50 and affects the middle and ring fingers most often. It is also linked to diabetes, with a lifetime incidence of 10% to 20% in these patients. Sometimes, if you have diabetes, multiple fingers may be involved. The problem is mechanical; the tissues simply do not glide past each other as they should, creating pain and the distinct catching sensation you feel.
What we can do about it
For many people, simple self-care helps ease symptoms. You might try resting your hand and avoiding repetitive grasping activities that strain the finger. Wearing a splint or orthosis can keep the finger straight and reduce irritation. These non-surgical steps aim to calm the inflammation in the tendon sheath. While some patients find relief this way, others may need more active treatment if the finger continues to catch or lock.
If self-care is not enough, your surgeon may suggest a corticosteroid injection into the flexor sheath. This medicine reduces swelling and often stops the triggering. About 60% of patients achieve success after just one injection. For those without diabetes, 65% to 90% get relief with one or two shots. The effect can last for a year or more in half of the patients who respond. However, diabetes can make injections less effective, and they may raise blood sugar levels for 5 days or more in diabetic patients. If you have unstable diabetes, your surgeon might recommend avoiding injections.
When injections do not work or the finger is locked, surgery is the next step. This procedure involves a small release of the tight band over the tendon to allow smooth movement. It is a short, safe procedure that is curative for most digits that do not respond to injections. About 97% of patients have complete resolution after this operation. Your surgeon will discuss whether this is right for you if conservative care has reached its limit.
When to see someone
See your GP if you have pain in the palm, a lump, or a finger that catches or locks. This is common in people over 45 and affects women more often. Ask for a specialist review if the finger locks in a bent position, if you need to use your other hand to straighten it, or if symptoms stop you from sleeping or working. Triggering is often worse in the morning. If you have diabetes, symptoms may be harder to treat with injections. Seek help if the problem persists despite rest, or if you notice sudden worsening, weakness, or signs of infection like redness and warmth.
