Wrist & hand
Trigger Finger (Stenosing Tenosynovitis)
Trigger finger is a finger or thumb that catches, clicks or locks when bending, caused by a thickened tendon catching in its sheath. Common over 40 and in diabetes.
Common symptoms
- A finger or thumb that clicks or catches when bending or straightening
- Stiffness in the finger, worst first thing in the morning
- A tender lump in the palm at the base of the finger
- The finger locking in a bent position and needing to be straightened by hand
- Pain in the palm when gripping
- More than one finger affected, particularly in diabetes
Overview
The tendons that bend your fingers run through a series of small tunnels, called pulleys, that keep them close to the bone. Trigger finger develops when the tendon, or the pulley at the base of the finger, becomes thickened or forms a small nodule. The tendon then struggles to glide through the pulley: it catches, and when it finally pulls through, the finger snaps straight with a click — like a trigger being released.
In the early stages there is stiffness and a tender lump in the palm at the base of the affected finger, often worst first thing in the morning. As it progresses the finger clicks when bending and straightening, and in more severe cases it locks in a bent position and has to be straightened with the other hand. The ring finger, middle finger and thumb are most commonly affected, and more than one finger can be involved.
Trigger finger is most common between the ages of 40 and 60, in women, and in people with diabetes, rheumatoid arthritis or thyroid conditions. It can also follow a period of heavy gripping. Mild cases often settle with activity changes and treatment over a few months; persistent locking usually needs a specialist opinion, as there are effective medical and surgical options.
Causes and risk factors
- Age 40–60, and more common in women
- Diabetes — trigger finger is considerably more common and often affects several fingers
- Rheumatoid arthritis, gout and thyroid disease
- Repetitive or forceful gripping: tools, gardening, racket sports, climbing
- A period of unusually heavy hand use
- Other hand conditions such as carpal tunnel syndrome or De Quervain's
How we may be able to help
We assess the finger to confirm trigger finger, grade how severe it is (stiffness only, clicking, or locking) and check for related conditions. If the finger is locking regularly, or you have diabetes with several fingers involved, we can arrange an online private GP consultation for a specialist referral, as these cases often need options we do not provide. We do not make splints; where a night splint to keep the finger straight is likely to help, we will advise.
For mild to moderate cases, physiotherapy offers tendon gliding exercises that encourage the tendon to move smoothly through the pulley, advice on reducing forceful gripping, and gentle soft tissue techniques to the palm and forearm. IASTM over the forearm flexor muscles can reduce overall tension on the tendon. Therapeutic ultrasound over the pulley at the base of the finger may help ease the thickening in early cases, and focused shockwave has been used for persistent trigger finger with some encouraging early evidence.
Treatment is reviewed after a few sessions. If a finger continues to lock, we would rather arrange a specialist opinion promptly than continue with treatment that is not helping.
What you can do at home
- Reduce forceful and prolonged gripping for now — use padded handles and lighter tools
- Gently massage the tender spot in the palm for a minute or two, a few times a day
- Do tendon gliding exercises: make a straight hand, a hook fist, a full fist and a flat fist in sequence, several times a day
- Soak the hand in warm water in the morning to ease stiffness before moving the fingers
- Avoid forcing a locked finger straight repeatedly; ease it out gently
- If you have diabetes, good blood sugar control supports tendon health
When to seek urgent help
If you have any of the following, call us straight away for an urgent same-day appointment — we can examine you and arrange fast-track X-ray or MRI through our imaging partner. If you cannot reach us, go to A&E. For loss of bladder or bowel control, numbness around the groin, chest pain, a sudden severe headache or rapidly worsening weakness, call 999 or go to A&E immediately:
- A hot, red, swollen finger with fever, or redness spreading up the hand — possible infection
- A finger that cannot be straightened at all after an injury
- Numbness or loss of feeling in the finger
- Pain and swelling in many joints with prolonged morning stiffness — possible inflammatory arthritis
Frequently asked questions
Will it go away by itself?
Mild trigger finger sometimes settles over a few months, especially if gripping is reduced. Fingers that lock regularly are less likely to resolve on their own and usually benefit from a specialist opinion.
Do I need an injection or surgery?
These are common and effective options for persistent trigger finger, and a specialist would discuss them with you. We can arrange that referral through our online GP service if conservative treatment is not helping.
Should I wear a splint at night?
A splint that holds the finger straight overnight helps many people with early trigger finger. We do not make splints, but we will advise whether one is likely to help and where to obtain one.
Can I still go climbing or lift weights?
Heavy, sustained gripping tends to aggravate trigger finger. We usually advise reducing grip-intensive training while the tendon settles and returning gradually. We will help you plan what to keep.
This page is general information, not a diagnosis. A clinician will assess you before recommending any treatment. Outcomes vary from person to person. Written with reference to NHS and other peer-reviewed guidance.
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