Trigger finger: treatment, symptoms, causes and recovery time

If symptoms persist or stop you doing everyday tasks, the NHS advises seeing a GP. The table sets out the options described by the NHS, BSSH and the national Evidence Based Intervention policy adopted by one integrated care board.

The NHS says the main symptom is a finger or thumb getting stuck in a bent position, with a clicking or popping feeling as it straightens. BSSH adds that pain is usually felt in the palm for fingers, or at the middle joint on the palm side of the thumb, and often in people over 40.

• Pain in the finger, thumb or palm, with tenderness if you press on the sore spot.

• Clicking, catching or locking, often worse on waking in the morning.

• Needing to press on the finger with the other hand to straighten it.

• Stiffness, especially in trigger thumb, where movement at the end joint may be reduced.

• Symptoms that are worse with gripping tasks such as preparing food, using tools or playing sport.

The tendons that bend your fingers run through narrow tunnels in the palm called sheaths. In trigger finger the tendon becomes thickened, or the mouth of the tunnel tightens, and the tendon catches as it moves. A hospital hand therapy leaflet describes the tendon forming a small lump, or nodule, that no longer slides easily.

The result is a finger that clicks, snaps or locks, a little like a trigger being pulled and released. In severe cases the finger stays locked in the palm until you straighten it with the other hand. The thumb can be affected as well and is called trigger thumb.

The NHS says it is not always known what causes trigger finger, though an injury is sometimes the trigger. BSSH says it can appear after a knock to the hand, and that there is little evidence work activities cause it, although using the hand at work, at home, in the garden or at sport can aggravate the pain.

People with insulin-dependent diabetes are especially prone, according to BSSH, and the NHS lists diabetes, rheumatoid arthritis and age over 40 as risks. BSSH says tendon nodules in people with rheumatoid arthritis can cause triggering, and that it is not caused by osteoarthritis.

It varies. BSSH says some mild cases recover over a few weeks without treatment, and the NHS says trigger finger can sometimes get better on its own. The Evidence Based Intervention policy says mild cases that cause no loss of function require no treatment and may resolve spontaneously.

With splinting and exercise, a hospital hand therapy leaflet says improvement is very likely but may take up to 12 weeks. For steroid injections, BSSH says improvement may occur within a few days but may take several weeks, and the policy says injections usually resolve troublesome trigger fingers within 1 week, though sometimes triggering keeps recurring.

After surgery, the policy says recovery takes 2 to 4 weeks. BSSH says light use of the hand is possible from the day of surgery, the wound needs a small dressing for 10 to 14 days, pain relief is usually rapid and the scar may be red and tender for several weeks.

The NHS says you can avoid or reduce activities that make symptoms worse until they improve, and take painkillers such as ibuprofen for pain. A hospital hand therapy leaflet adds exercises to keep the finger mobile, carried out 4 to 5 times a day, and suggests over-the-counter pain relief or anti-inflammatory gels.

Night splinting is a common step. BSSH explains that holding the finger straight at night keeps the roughened part of the tendon in the tunnel and lets it become smoother, and that a hand therapist can fit a small splint. The hand therapy leaflet says following its advice may bring improvement over up to 12 weeks.

In many areas the NHS says you can refer yourself to community musculoskeletal (MSK) services, such as physiotherapy, without seeing a GP first.

The NHS says surgery is only done if other treatments have not worked. The Evidence Based Intervention policy says surgery should be considered if triggering persists or recurs after splinting or injection, if the finger is permanently locked in the palm, or in people with diabetes.

BSSH says the operation can be done under local, regional or general anaesthetic. The surgeon widens the tendon tunnel through a small incision while protecting nearby nerves. The wound needs a small dressing for 10 to 14 days, light use of the hand is possible from the day of surgery, and the scar may be red and tender for several weeks.

The policy lists infection, numbness, stiffness and a tender scar as risks, usually temporary. It says problems after surgery are rare, at under 3%.

The NHS says to see a GP if you think you have trigger finger and your symptoms do not get better, or if your symptoms stop you doing your usual daily activities. In many areas you may be able to get help such as physiotherapy from NHS community musculoskeletal (MSK) services without needing a referral from a GP.

The NHS pages do not list trigger finger as an emergency. If a finger becomes hot, red, swollen and feverish, or a wound after an injection or operation looks infected, contact your GP or NHS 111 the same day.

The Evidence Based Intervention policy says trigger finger is often no more than a nuisance and doing nothing will not be harmful to health. BSSH says recurrence of triggering after surgery is uncommon, and that a second injection is sometimes helpful, but surgery may be needed if triggering persists.

The policy says that the problem may recur after steroid injection, especially in people with diabetes, and that surgery should be considered for people who have diabetes, whose finger is permanently locked in the palm, or whose triggering persists or recurs after splinting or injection.

On the NHS, a GP or direct access to MSK physiotherapy leads to hand therapy, injection and surgery pathways. National Evidence Based Intervention policy, adopted by NHS integrated care boards, sets out when surgery should be considered.

Some people choose to see a private hand surgeon or hand therapist. The graded steps are the same, and it helps to ask which stage of treatment is being proposed and why, and to share any procedure details with your GP.