Trigger Finger & Trigger Thumb

What is Trigger Finger & Trigger Thumb?

Trigger finger and trigger thumb, medically known as stenosing tenosynovitis, are conditions in which the digit becomes temporarily or permanently locked in a bent position. The issue causes the finger or thumb to 'catch', 'click' or trigger when straightened. In severe cases, the digit may become fixed in a bent position and cannot be straightened.

Triggering arises when inflammation and thickening of the tendon sheath at the base of the digi (A1 pulley) narrows the tunnel through which the flexor tendon runs. The tendon struggles to glide freely through the constriction, producing the characteristic catching sensation.

What causes Trigger Finger & Trigger Thumb?

• Repetitive gripping or pinching activities causing chronic friction along the tendon expansion
• Rheumatoid arthritis and other inflammatory arthropathies causing tendon sheath thickening
• Diabetes, a well-recognised risk factor
• Underactive thyroid and other systemic conditions associated with tendon changes
• Direct blunt trauma to the palm at the base of the finger or thumb
• Idiopathic: no specific identifiable cause in many cases

Signs & symptoms

• A catching, clicking or locking sensation when bending or straightening the finger or thumb
• Pain at the base of the finger or thumb in the palm, particularly on gripping
• A tender nodule palpable at the base of the affected finger or thumb in the palm
• Morning stiffness: the finger may be more locked in the morning and loosen during the day
• In severe cases, the digit becomes fixed in a bent position and cannot be straightened

How Hand Therapy can help

Ms Razo provides specialist assessment and evidence-based treatment for Trigger Finger & Trigger Thumb. Following a thorough initial assessment, a personalised treatment plan will be developed to address your specific needs and goals.

Frequently asked questions

Can trigger finger or trigger thumb resolve on their own?

Mild triggering can occasionally settle with rest and activity modification alone. However, without treatment it often persists or progresses. Splinting and Hand Therapy are effective non-operative management options.

Is surgery always needed for trigger finger or trigger thumb?

No. Many cases of triggering respond well to non-operative management. Surgery, involving a simple procedure to release the A1 pulley, is typically reserved for cases where non-opereative measures have failed, or for fixed triggering that cannot be passively corrected.

What is an A1 pulley release?

A1 pulley release is a minor surgical procedure in which the fibrous band (A1 pulley) along the base of the finger or thumb is divided to widen the tunnel through which the flexor tendon runs. This resolves the mechanical obstruction causing triggering. Ms Razo provides post-operative Hand Therapy following this procedure.

Can trigger finger or trigger thumb come back after treatment?

Recurrence after Hand Therapy or corticosteroid injection is possible, particularly in patients with diabetes or multiple affected fingers. Recurrence after surgical A1 pulley release is uncommon. Ms Razo will advise on reducing the risk of recurrence.