Ask An Expert: Trigger Finger

Content provided by the Faculty of the Harvard Medical School

Ask An Expert: Trigger Finger

Question:

What causes "trigger finger," and what can you do to alleviate the pain? I have this problem with my left ring finger.

Answer:

Trigger finger is a condition in which the finger becomes stuck in a bent position. Some force is required to straighten it out, and when it does straighten, it may do so suddenly, with a painful click or pop — a bit like pulling a trigger. This may due to a form of tendonitis (tendon inflammation) that develops when a portion of the finger's tendon is enlarged or nodular. The tendon gets stuck in the tube (called the tendon sheath) through which it travels when the finger bends and straightens. Trigger finger also may develop if the tendon sheath is inflamed or narrowed.

The causes of or contributors to trigger finger are the same as those that cause tendonitis, including overuse, forms of arthritis that also cause tendonitis (such as rheumatoid arthritis), and diabetes. It's a bit more common in women than men. Often, there is no clear explanation or cause for trigger finger.

Treatment starts with simple things, such as anti-inflammatory medications, rest and time. Heat and massage may help. If the condition is persistent, a splint can be worn over the involved finger. Resting the tendon with an immobilizing splint can help the inflammation to subside.

Cortisone injections can reduce inflammation and relieve symptoms as well, but these cannot be performed too often. A common recommendation is no more than three injections in one area each year. Surgery can be offered as a last resort. A hand surgeon can remove inflamed tissue and open up the tendon sheath, allowing the tendon more room in which to move. Surgery may be the only effective therapy if there is a large tendon nodule.

Robert Shmerling, M.D., is associate physician and clinical chief of rheumatology at Beth Israel Deaconess Medical Center and an associate professor in medicine at Harvard Medical School. He is an active teacher in the Internal Medicine Residency Program, serving as the Robinson Firm Chief. He is also a teacher in the Rheumatology Fellowship Program and has been a practicing rheumatologist for over 25 years.

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Last updated:	January 24, 2007

Medical content reviewed by the Faculty of the Harvard Medical School. Harvard Health Publications, Copyright © 2007 by President and Fellows of Harvard College. All rights reserved. Used with permission of StayWell.

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