Trigger finger / thumb

Patient Information

https://patient.info/bones-joints-muscles/tendinopathy-and-tenosynovitis-tendinosis/trigger-finger

GP Information

Background Information

• Inflammation of the flexor sheath or tendon resulting in entrapment at the A1 pulley.
• Associated with diabetes, rheumatoid arthritis and amyloidosis.
• Patients typically complain of finger clicking, pain at the base of the finger and catching or locking of the finger.
• Examination may reveal a palpable nodule in the palm overlying the MPCJ with a catching sensation as the nodule enters the pulley, or a finger locked in flexion.

Investigation Guidelines

• Investigations are not required for treatment or prior to referral.

Management Recommendations

• Initial management is conservative.
• Explanation and advice.
• Up to 3 steroid injections 1 month apart may be given into the flexor sheath at the A1 pulley if skilled (50% success in diabetics and not recommended in the thumb due to risk of damage to digital nerves).
• Referral indications: Diagnostic uncertainty, referral for steroid injection, failure to respond to steroid injection, surgery required.