Trigger thumb can cause pain at the base of the thumb, clicking during movement or a thumb that catches and locks. The underlying issue is usually reduced smoothness where the flexor tendon passes through a pulley.
Because the thumb is involved in pinch and grasp, even intermittent catching can be frustrating. Evaluation also considers the thumb joints, sensation and any previous injury.
Typical symptoms
- Pain or tenderness at the palm-side base of the thumb
- Clicking, catching or a thumb that locks in a bent position
- Morning stiffness or pain when opening jars and gripping
- A tender nodule over the pulley
Treatment without surgery
A period of reducing aggravating activities, a night splint and hand therapy may help the tendon glide. A corticosteroid injection is another option in selected adults. The risks and expected duration of relief should be discussed before an injection.
Trigger thumb release
If the thumb remains painful or locked despite nonsurgical care, release of the constricting pulley may be considered. The operation is intended to restore tendon glide, followed by motion as the wound permits. Recovery is influenced by swelling, pre-existing stiffness and the demands placed on the hand.
When to seek an evaluation
Arrange an evaluation if the thumb is repeatedly locking, if you need the other hand to straighten it, or if pain is interfering with work or sleep. Sudden severe swelling, loss of sensation or a thumb that becomes pale or cold needs prompt attention.
Sources and further reading
Frequently asked questions
Can trigger thumb get better on its own?
It can, particularly when symptoms are mild and the thumb is protected from repeated aggravation. A clinician can help decide how long observation is reasonable.
Is trigger thumb different from thumb arthritis?
Yes. Trigger thumb is a tendon-and-pulley gliding problem, while arthritis affects a joint. Both can cause pain with grasping, so examination matters.