Signs /Symptoms

  • Nodule at level of A1 Pulley (over Palmar MCPJ) – palpate this area and ask patient to flex – nodule usually obvious.
  • Patient may feel a “CLICK”
  • Locking may be actively correctable i.e. patient can force straight again, or passively correctable whereby need to pull straight with other hand.
  • Nodules may be painful especially if in contact with objects in the palm as when gripping

Advice in Primary Care

  • Spontaneous recovery may occur
  • Try a finger splint as per information in advice sheet
  • Avoid Prolonged flexion when gripping onto objects
  • Try icing over nodule to reduce inflammation around tendon
  • Activity modification – reduce repetitive tasks, take regular stretch breaks

Actions in Primary Care

  • Issue leaflet to patient and encourage to try a splint intermittently for 6 weeks
  • Direct Patient to NHS Inform Website for further info - https://www.nhs.uk/conditions/trigger-finger/
  • Try steroid injection by appropriately trained Healthcare Practitioner if these skills are available in Surgery – if not refer to OT Hand clinic for injection (less successful in Diabetic Patients)
  • Repeat only once if initial relief temporary
  • Surgical release may be required if symptoms persist

Referral to Secondary Care

  • If symptoms persist following 6-8 weeks of self management
  • No Active Flexion / Finger completely locked in flexion or unable to initiate active flexion

Refer via SCI Gateway to Occupational Therapy Hand Clinic and include following in referral:

  • Duration of symptoms
  • Duration of self management inc splint
  • Precipitating factors i.e. injury/trauma, occupation

Editorial Information

Last reviewed: 23/01/2024

Next review date: 23/01/2026

Version: 1

Reviewer name(s): Jan Beaumont.