Trigger Finger

What is trigger finger?

Trigger finger is a condition in which one of your fingers gets stuck in a bent position. Your finger may bend or straighten with a snap — like a trigger being pulled and released. Trigger finger is also known as stenosing tenosynovitis.

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Dr. Bert Perey, MD, FRCPC, Orthopedic Surgeon, discusses trigger finger causes and symptoms.

Dr. Bert Perey, MD, FRCPC, Orthopedic Surgeon talks about the treatment options available to patients with trigger finger.

Dr. Bert Perey, MD, FRCPC, Orthopedic Surgeon, discusses trigger finger symptoms, diagnosis and treatment including surgical options.

What is trigger finger and how is it caused?

Trigger finger is compression of the tendons at the base of your fingers. It can occur in any digit, it can occur in the thumb and the index, the long finger. And it’s identified primarily by pain. Most patients who have this have pain.

The word “trigger” comes in because one of the traditional symptoms that they have is that the finger locks. It locks, usually in the morning, and then one has to unlock and then it clicks. So they call that trigger finger.

But not all patients have that true locking that they can present with pain. They can present with a stiff finger, a stiff finger that you either can’t bend or can’t straighten. Or it presents with locking.

Some patients in advanced stages have a finger that’s, in fact, bent that cannot straighten out. Usually it’s painful. Most of the pain is at the base of the digits in the palm. Some patients feel it in the small joints of their hand, and in fact, they think that the problem comes from the small joint when in fact the problem is coming from the lower base of the hand.

The reason why we get this is not really very well understood. We don’t know what sets this in motion, but essentially the tendon travels through a tunnel at the base of the finger. We call this tunnel the pulley system of the fingers. It starts at the base of the finger and goes to the end of the finger.

As there’s constriction that occurs, either from swelling of the tunnel, or swelling of the tendon, the tendon gets tight within that tunnel and can’t glide as well. So patients present with limited motion, pain, or as described earlier, that triggering/locking effect.

Trigger fingers occur spontaneously; exactly, it’s idiopathic, like many conditions in the hand. It’s not due to anything you’ve done, anything you’ve eaten, or anything you may have taken in the past; it’s spontaneous.

Most of it occurs in patients around their fifth or sixth decade, although they can occur in 30-year-olds or 80-year-olds. There tend to be slightly higher predominance in women, again, for reasons why we don’t know. It tends to occur in all digits, so there’s not one digit they’re more likely to occur in than the other.

And it can occur in your left hand or your right hand independent of your hand dominance. Usually it starts with one finger. It can have a traumatic onset in some patients where they sustain a relatively minor injury, and a few weeks later they start locking their finger and thusly attribute their injury to the cause of the problem.

It’s probably more like the straw that broke the camel’s back, where the injury just precipitated this condition that was more likely to happen even if the injury didn’t occur.

If you have more questions about trigger finger, or think you may be experiencing trigger finger yourself, you should seek attention by your family physician.

Presenter: Dr. Bertrand Perey, Orthopaedic Surgeon, New Westminster, BC

Local Practitioners: Orthopaedic Surgeon

Quiz: Do You Understand Trigger Finger?

Test your knowledge by answering the following questions:


Trigger finger usually starts in one digit.

The tendon that is affected travels through a tunnel at the base of the finger (think of it as the pulley system of the fingers). As constriction occurs, either from swelling of the tunnel or of the tendon, the finger locks up. Trigger finger usually starts in one digit.

Doctors know exactly what causes trigger finger.

It’s not well understood what cause trigger finger. It occurs spontaneously, like many conditions in the hand.

People in their 70s and 80s are most commonly affected.

People in their 50s and 60s are most commonly affected, although it can occur in younger and older patients as well. There tends to be a slightly higher predominance among women.

If you have trigger finger, surgery is an option.

If you have trigger finger, your physician and/or orthopedic surgeon may recommend surgery. This involves an incision in the palm, which causes a temporary scar reaction in the palm due to the glabrous skin (like the skin of the foot).

Scarring should resolve completely over a period of many months.

Scarring resolves completely over a period of many months, unless a patient experiences abnormal scarring. If this happens a patient should seek attention from a physiotherapist for scar massage and scar-improvement tools.
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