- Typical painful nodule at base of thumb or finger
- Wake up with flexed finger or thumb which can be straightened with a click
- Progresses to triggering/locking on flexion activity through the day
- HOWEVER - Spontaneous recovery may occur in up to 29% of patients
- Can be associated with diabetes, thyroid problems, and arthritis.
Trigger Finger/Thumb
Symptoms and signs
Initial management
- Splinting non-invasive and may provide short-term relief. Splint can be bought online (Google search 'trigger finger splint')
- Modification of activity to avoid pressure on this area (e.g. adjust grip)
- Analgesia & NSAIDs as appropriate
- Corticosteroid Steroid injection (70-90%% success rate, less if diabetic). May be repeated once if initial injection gives only temporary relief. Can be done by appropriately trained practitioner. Refer to MSK Physiotherapy if not able to administer in GP Practice.
Useful resources
Who to refer
- Triggering recurs after injection and willing to consider further intervention.
- Urgent referral if finger locked in flexion (please ensure symptoms are not due to Dupuytren's)
Who not to refer
Symptoms less than 6 weeks duration with no conservative treatment tried.
How to refer
- If being seen by MSK physiotherapy service, onward referral to hand service will be organised by physiotherapist.
- SCI Gateway/Hand Surgery. Patients will be appointed to Advanced Practice Physiotherapist initially.
Include the following information:
- Duration of symptoms and any cause of onset
- Conservative management tried (e.g. any relief through activity avoidance, splinting, injection?)
- Dominance, effect on work/ADL/hobbies, movement loss