Trigger Finger (Stenosing Tenosynovitis)

What Is Trigger Finger (Stenosing Tenosynovitis)?

Stenosing tenosynovitis is also known as trigger finger and is one of the most common problems of the hand. Trigger finger is an inflammation of the flexor tendons. Tendons glide through a pulley system in each finger, similar to the way that a fishing wire glides through pulleys along a fishing pole. Just as this system keeps the fishing wire next to the pole, the tendons are held next to the bones of the finger, to prevent bowstringing of the tendon. Sometimes the tendons can become inflamed in areas, making it difficult for the tendon to easily glide when the fingers are straightening or bending.  

The affected finger gets stuck in a bent position and then may straighten in a snap. In more severe cases, the finger can get stuck in the bent position. 

At the Yale Hand and Microsurgery Program, our model of comprehensive care provides for complete treatment. Our goal is to reduce or eliminate the symptoms associated with stenosing tenosynovitis. 


Causes of Trigger Finger (Stenosing Tenosynovitis)

Your flexor tendons can become inflamed from repetitive strain, injury, or overuse and inflammatory diseases such as rheumatoid arthritis. 

Once you have trigger finger, each catch can cause the tendon to become irritated and inflamed, worsening the problem. The longer the inflammation lasts, the more scarring and thickening can occur. 

At the Yale Hand and Microsurgery Program, we will help determine if the cause of your stenosing tenosynovitis is related to repetitive strain so that we can incorporate modifying specific work and daily activities as an important part of your comprehensive treatment plan. 

Symptoms of Trigger Finger (Stenosing Tenosynovitis)

Trigger finger symptoms include: 

  • Finger stiffness, particularly in the morning
  • A clicking sensation as you move your finger
  • Tenderness in the affected finger
  • A bump at the base of the affected finger
  • Finger locking in a bent position, which suddenly pops straight
  • Finger locked in a bent position, which you are unable to straighten

Though trigger finger can occur in either hand, it most commonly occurs in your dominant hand and affects your thumb or your middle or ring finger. You may experience trigger finger in more than one finger at a time.  

You may notice that triggering is more pronounced:

  • In the morning
  • While firmly grasping an object
  • When straightening your finger

At the Yale Hand and Microsurgery Program, our surgeons can generally diagnose trigger finger by understanding your history of symptoms and by an exam. Often, patients will have the telltale painful clicking and popping associated with trigger finger without any history of trauma.

This list should be used as a guideline. Not every symptom is included. If you or a loved one has one or more of these symptoms, it does not mean that he or she has trigger finger. If you are concerned that you or a loved one might have trigger finger, please make an appointment with your doctor.

Treatments for Trigger Finger (Stenosing Tenosynovitis)

One of the most common questions regarding trigger finger is if the condition will heal without surgery. 

Generally, trigger finger treatment is a direct injection of steroids into the tendon sheath. This treatment is successful in a large number of patients. 

However, if you have multiple fingers affected, then you may require surgical release of the tendons. At the Yale Hand and Microsurgery Program, our surgeons, J. Grant Thomson, MD, FRCS, FACS, and Michael Matthew, MD, specialize in hand surgery and working with the delicate structures in the fingers.