Trigger Finger

 

Mild cases which cause no loss of function require no treatment or avoidance of activities which precipitate triggering and may resolve spontaneously.

 

Conservative Management

Cases interfering with activities or causing pain should first be treated with:

• Activity modification/NSAIDs
• Hand Therapy
• One or two steroid injections (usually resolve troublesome trigger fingers within 1 week, but the problem may recur, especially in diabetics)
• Splinting of the affected finger for 3-12 weeks

 

When to Refer for Surgery

• Triggering persists or recurs following conservative measures (particularly following a trial of up to 2 steroid injections if the first injection gives some benefit) If the patient is diabetic refer if failing to respond or recurs after a trial of 1 steroid injection

OR

• The finger is permanently locked in the palm

OR

• The patient has previously had 2 other trigger digits unsuccessfully treated with appropriate nonoperative methods

AND

• The patient wishes to undergo surgery

If symptoms fail to resolve, or there are extenuating circumstance that lead to a patient deciding against injection, then the next line of treatment may be either an open or percutaneous release of the constricted pulley (high evidence).

Recurrence of triggering after surgery is uncommon.

 

References

1. British Society Surgery of the Hand – Evidence for Surgical Treatment (BEST) Evidence based management of adult trigger digits, October 2016.  
2. Trigger finger release in adults (National Evidence Based Intervention). 
3. Cornwall and IoS Commissioning policy and Evidence Based Interventions, April 2025

 

Page Review Information

Partial Review Date           13 May 2025 Partial update

Next review due                 13 May 2026

Sifter name                         Dr Laura Lomas

      Dr Rebecca Hopkins