Easing in warm water
Put your hand in warm water and gently straighten your finger under the water. If your finger is stuck when you wake up, starting the day this way makes movement easier. Do not force it.
In the morning and when neededCondition guide
Trigger finger is when the tendon that bends the finger thickens and catches in the tunnel it passes through: the finger stays bent and releases with a “click” when you straighten it. It is not a harmful condition, but it makes the hand harder to use. Mild cases can settle with rest, a night splint and gentle movements; if it does not go away, an injection and a small operation are options.
The tendons that bend the fingers glide through small tunnels attached to the bone. When the tendon or its sheath swells and thickens, it catches at the mouth of the tunnel; sometimes a small nodule forms. The nodule passes through the tunnel as the finger bends, catches as it straightens and then suddenly releases, like a trigger being pulled and let go.
Often the cause is not known; sometimes it starts after an injury. It is more common over the age of 40, in women, and in people with diabetes or rheumatoid arthritis. Repetitive tasks that need a firm grip, such as using scissors or secateurs, can also set it off.
Cut down on tasks that make the symptoms worse, especially repetitive and firm gripping, until things improve. The longer the finger stays stuck in a bent position, the more irritated and thickened the tendon becomes; that is why acting early matters.
A night splint is the most effective tool at this stage: a short splint that limits movement at the base of the finger rests the tendon and the tunnel and reduces triggering in the morning. It is worn through the night; a hand therapist can make one that suits you. Applying anti-inflammatory gel to the base of the finger at night may also help; ask your pharmacist first.
Improvement with a splint and movements can take up to 12 weeks. If the finger triggers constantly, or you have to use your other hand to straighten it, a steroid injection is considered; if the injection is not enough either, a small operation is done to release the tunnel.
Care at home
Do the movements without forcing and without making the finger “snap”. If it catches, make the movement smaller. All of them come from the hand therapy leaflets of UK hospitals.
Put your hand in warm water and gently straighten your finger under the water. If your finger is stuck when you wake up, starting the day this way makes movement easier. Do not force it.
In the morning and when neededPut a little baby oil on the base of your finger. Wrap an ice cube in cling film or a thin cloth and rub it firmly over the base of the finger until the ice has melted. The aim is to reduce the swelling in the area.
Until the ice has melted, once a dayStart with your fingers straight. Keeping the knuckles at the base of the fingers straight, curl the tips into a hook; then close your fingers into a full fist and open them again.
10 repetitions, 4–5 times a dayStart with your fingers straight. Bend forwards only at the knuckles at the base of the fingers, keeping the fingers flat like a tabletop. Then straighten again.
10 repetitions, 4–5 times a dayWith your good hand, gently close the fingers of the affected hand into a fist; the fingers themselves should not tense. Then let go. This keeps the joints moving without straining the tendon.
5–10 repetitions, 4 times a dayWear the splint your hand therapist gave you, or a short splint that limits movement at the base of the finger, through the night. The tendon and the tunnel it passes through rest, and triggering in the morning is reduced. If your skin becomes red or the splint rubs, let your therapist know.
Every night; your therapist decides for how longVideo
From the YouTube channels of Mayo Clinic in the USA and of Dr James O’Donovan, a doctor in the UK.
A video summarising the condition and the treatment options.
An exercise video presented by a doctor and a physiotherapist.
Mild cases can get better in a few weeks without treatment. In some people, however, it comes back from time to time or becomes long-term. The longer the finger stays stuck in a bent position, the more irritated the tendon becomes; that is why resting the hand early, a night splint and gentle movements matter. When the advice is followed, improvement can take up to 12 weeks.
According to the national patient leaflet in Scotland, the injection relieves pain and triggering in about 70–80% of cases; success is lower in people with diabetes. Randomised controlled research, however, is scarce: the Cochrane review found two small trials of 63 people; at four weeks, treatment was successful in 37 out of 100 of those given a steroid and 17 out of 100 of those given local anaesthetic alone.
In most people the symptoms are more noticeable in the morning. A short splint that limits movement at the base of the finger through the night is very effective at reducing morning triggering. Putting your hand in warm water when you wake and gently straightening your finger also makes movement easier; do not force it open.
Most people do not need it. If other methods do not work, the tunnel the tendon passes through is released in a small procedure, usually under local anaesthetic. A small dressing stays on for 10–14 days, and the hand can be used for light tasks the same day. It rarely comes back.
See a doctor in the following situations:
Sources