Trigger Finger (Jari Terkunci): Tanda, Punca & Rawatan

Trigger finger (jari terkunci) is a condition where a finger or thumb gets stuck in a bent position and then straightens with a painful click or pop. It happens when a tendon in the finger, or the tunnel it slides through, becomes thickened. It is most common in women aged 40 to 60 and in people with diabetes. Mild cases can get better with rest, a night splint and gentle exercises; a steroid injection or a small operation can help if it does not. This guide explains the signs, causes, exercises, treatment and surgery for trigger finger and trigger thumb.

Apa itu trigger finger (jari terkunci)?

Trigger finger is also called stenosing tenosynovitis. When it affects the thumb, it is called trigger thumb.

The American Academy of Orthopaedic Surgeons (AAOS) explains how it happens:

• the flexor tendons that bend your fingers run along the palm side of the hand and pass through a series of tunnels called pulleys, which keep them close to the bone;
• the pulley at the base of each finger, in the palm, is called the A1 pulley. This is the one most involved in trigger finger;
• in trigger finger, the tendon can become thickened or develop a small lump (nodule), and the pulley can become thicker and narrower;
• the tendon then cannot glide smoothly, so it catches when you bend the finger and snaps through when you straighten it, often painfully.

AAOS says trigger finger affects about 2% of people. It can affect one or several fingers, in one or both hands, and is most common in the ring finger and thumb. The British Society for Surgery of the Hand (BSSH) notes that it is not harmful, but it can be a painful nuisance.

Tanda trigger finger: symptoms

According to the NHS, AAOS and BSSH, symptoms include:

• a finger or thumb that gets stuck in a bent position;
• a clicking, popping or catching feeling when you bend or straighten it;
• pain in the finger, thumb or palm, especially at the base of the finger, which can spread into the finger or palm;
• a tender lump at the base of the finger or thumb on the palm side;
• stiffness, especially in trigger thumb;
• needing to use your other hand to straighten the finger.

Symptoms often start slowly and get worse over time (AAOS). They are usually worse in the morning after the hand has been still overnight, and when using your hands, such as preparing food, using tools or playing sport (NHS). AAOS says symptoms may improve during the day with gentle use. In the worst cases, the finger cannot be straightened at all without a doctor's help.

Punca trigger finger and who gets it

The NHS and AAOS say it is often not clear what causes trigger finger. Symptoms often start on their own, and sometimes after an injury such as a knock to the hand. BSSH says there is little evidence that it is caused by work, although hand use at work, at home or in sport can make the pain worse.

You are more likely to get trigger finger if you:

• are over 40, and especially if you are a woman aged 40 to 60 (NHS, AAOS);
• have diabetes. BSSH says people with insulin-dependent diabetes are especially prone to triggering, although most people with trigger finger do not have diabetes (see our guide to kencing manis);
• have rheumatoid arthritis, which can cause tendon nodules (BSSH), or amyloidosis (AAOS);
• do a lot of repetitive gripping or pinching, for work or hobbies (AAOS). An NHS hand therapy leaflet gives scissors and garden secateurs as examples of tasks that can aggravate it.

Why this matters in Malaysia: diabetes is common here. The National Health and Morbidity Survey (NHMS) 2023 found that 15.6% of the population surveyed had diabetes, and younger people were more likely to have undiagnosed diabetes.

BSSH notes that trigger finger is not caused by osteoarthritis.

How doctors diagnose trigger finger

AAOS says a doctor can usually diagnose trigger finger by asking about your symptoms and examining your hand. X-rays or other tests are usually not needed. The doctor will look for:

• tenderness over the tendon in the palm;
• thickening or swelling at the base of the finger or thumb;
• clicking or catching when you bend and straighten the finger.

If your main symptom is numbness or tingling rather than locking, see our guide to tangan kebas, which covers carpal tunnel syndrome and other causes.

Cara rawat trigger finger at home

The NHS says trigger finger can sometimes get better on its own, and BSSH says some mild cases recover over a few weeks without treatment. Things you can try:

• Rest the finger. Avoid or cut down on activities that make it worse, especially repetitive gripping, until symptoms improve (NHS, AAOS).
• Painkillers. The NHS suggests ibuprofen. AAOS says anti-inflammatory painkillers such as ibuprofen or naproxen can help with pain and inflammation, and paracetamol is an option if you cannot take them. An NHS hand therapy leaflet adds that an anti-inflammatory gel, such as ibuprofen gel, may help; check with a pharmacist first if you have other medical conditions.
• Wear a splint at night. AAOS and BSSH suggest a small splint that keeps the finger straight while you sleep. BSSH explains that this keeps the roughened part of the tendon inside the tunnel and helps it become smoother, and that a hand therapist can fit one. Another NHS leaflet suggests a short splint that limits movement only at the base of the finger.
• Straighten the finger gently. An NHS hand therapy leaflet says soaking your hand in warm water can help ease a stuck finger straight again, and warns that forcing it can be painful.
• Do gentle exercises to keep the finger moving (see below).

An NHS hand therapy leaflet from North Tees and Hartlepool says that if you follow this advice and do the exercises, symptoms are very likely to improve, but this may take up to 12 weeks.

Trigger finger exercises (senaman)

AAOS says gentle stretching exercises can help reduce stiffness and improve movement. The North Tees and Hartlepool NHS hand therapy leaflet suggests these exercises, 4 to 5 times a day:

1. Hook and fist: start with your fingers straight. Bend them into a hook, keeping the big knuckles at the base of the fingers straight. Then bend your fingers down to make a full fist. Repeat 10 times.
2. Table top: start with your fingers straight. Bend them forward at the big knuckles only, keeping the fingers straight, like a flat table top. Then, keeping the fingertips straight, bend the fingers further down towards the wrist. Repeat 10 times.

A Torbay and South Devon NHS leaflet describes similar tendon gliding exercises, including gently using your other hand to push your fingers into a fist, and suggests 5 to 10 of each, 4 times a day.

Straighten your finger gently, as the Torbay leaflet notes that straightening it can be painful. A physiotherapist or hand therapist can show you exercises suited to you.

Rawatan trigger finger (treatment)

If your symptoms do not go away, a doctor may suggest further treatment. AAOS says most trigger fingers respond well to non-surgical treatment.

If you have diabetes: AAOS says a steroid injection typically raises blood sugar for about 10 to 14 days in people with diabetes who take insulin, so check your blood sugar closely and tell your doctor about your diabetes before the injection.

Trigger finger surgery and recovery

AAOS says surgery may be needed if your symptoms are severe, if they do not get better with other treatments, or if your finger is stuck bent and cannot be straightened.

What happens:

• it is a day procedure: you go home the same day (AAOS);
• the hand is usually numbed with an injection, and you can be awake or lightly sedated (AAOS). BSSH says a regional or general anaesthetic is sometimes used;
• through a small cut in the palm, the surgeon opens the tight A1 pulley, giving the tendon room to move. AAOS says opening this pulley does not affect how your hand works, as long as the other pulleys are left in place.

In Malaysia, some hospitals do finger operations such as trigger finger release with a wide-awake technique that uses only a local anaesthetic, without sedation or a tourniquet (WALANT). A review of 1,073 finger and hand operations done this way at a university hospital in Kuala Lumpur between 2016 and 2021 found no cases of problems with blood flow to the fingers.

Recovery:

• BSSH says light use of the hand is possible from the day of surgery, and moving the finger helps it recover. AAOS says most people are told to start moving their fingers straight away;
• keeping your hand raised above your heart can reduce pain and swelling (AAOS);
• BSSH says the wound needs a small dressing for 10 to 14 days, and pain relief is usually quick. The scar may be red and tender for several weeks;
• AAOS says the cut usually heals within a few weeks, but it can take 4 to 6 months for swelling and stiffness to go completely, and most people feel fully recovered after about 6 months.

Complications are rare but can include infection, stiffness or the triggering coming back (AAOS). BSSH says recurrence after surgery is uncommon.

When to see a doctor

The NHS advises seeing a doctor if:

• you think you have trigger finger and your symptoms do not get better;
• your symptoms stop you doing your usual daily activities.

Also see a doctor if your finger is locked in a bent position and you cannot straighten it. In Malaysia, you can start at a klinik kesihatan or a GP, who can refer you to a physiotherapist, an orthopaedic surgeon or a hand surgeon if needed. AAOS says early treatment and following your treatment plan are key to a good recovery.

Frequently asked questions (FAQ)

Apa itu trigger finger (what is trigger finger in Malay)?

Trigger finger, sometimes called jari terkunci in Malay, is a condition where a finger or thumb gets stuck in a bent position and then straightens with a click or pop, like a trigger being pulled and released. It happens when a tendon in the finger, or the tunnel it slides through, becomes thickened. When it affects the thumb, it is called trigger thumb.

Apa punca trigger finger (what causes trigger finger)?

Often there is no clear cause. It happens when the tendon that bends the finger, or the tunnel it passes through at the base of the finger, becomes thickened, so the tendon catches. It is more common in people over 40, especially women aged 40 to 60, and in people with diabetes or rheumatoid arthritis. Repetitive gripping can make the pain worse.

Boleh ke trigger finger sembuh sendiri (can trigger finger go away on its own)?

Yes, some mild cases get better on their own over a few weeks. Resting from activities that make it worse, painkillers such as ibuprofen, a splint at night and gentle exercises can help. An NHS hand therapy leaflet says improvement may take up to 12 weeks. See a doctor if it does not improve or stops you doing daily activities.

Apa senaman untuk trigger finger (what exercises help trigger finger)?

NHS hand therapists suggest gentle tendon gliding exercises 4 to 5 times a day: start with straight fingers, bend them into a hook keeping the knuckles straight, then make a full fist; and bend the fingers only at the knuckles like a flat table top. Repeat each about 10 times. Straighten the finger gently, as forcing it can be painful.

Does a steroid injection work for trigger finger?

A steroid injection at the base of the finger is a common first treatment. The British Society for Surgery of the Hand says it relieves pain and triggering in about 70% of cases, but works less well in people with diabetes. In people with diabetes who use insulin, it can raise blood sugar for about 10 to 14 days, so monitor closely.

Bila perlu pembedahan trigger finger (when is surgery needed)?

Surgery, called trigger finger release, is usually considered if symptoms are severe, if other treatments including steroid injections have not worked, or if the finger is stuck bent and cannot be straightened. It is a short day procedure, usually under local anaesthetic, that widens the tight tunnel so the tendon can glide. Most people can use the hand lightly the same day.

Is trigger finger linked to diabetes (kencing manis)?

Yes. Diabetes is one of the main risk factors for trigger finger, and the British Society for Surgery of the Hand says people with insulin-dependent diabetes are especially prone to it. Steroid injections also tend to work less well in people with diabetes. In Malaysia, the National Health and Morbidity Survey 2023 found that 15.6% of the population surveyed had diabetes.

Disclaimer

This article is for general information only and is not a substitute for advice, diagnosis or treatment from a doctor. Health supplements are not intended to diagnose, treat, cure or prevent any disease.

References

• Trigger finger — NHS
• Trigger finger — OrthoInfo, American Academy of Orthopaedic Surgeons (AAOS)
• Trigger finger/thumb — British Society for Surgery of the Hand (BSSH)
• Hand therapy: trigger finger — North Tees and Hartlepool NHS Foundation Trust
• Trigger finger: management and advice — Torbay and South Devon NHS Foundation Trust
• Conducting the National Health and Morbidity Survey 2023 in Malaysia with focus on methodology and main findings on non-communicable diseases — Scientific Reports
• Abdullah S, et al. A review of 1073 cases of Wide-Awake-Local-Anaesthesia-No-Tourniquet (WALANT) in finger and hand surgeries in an urban hospital in Malaysia. Cureus. 2021;13(7):e16269.