Trigger thumb factsheet
Introduction
Fingers and thumbs can bend and straighten because of the muscles and tendons in the hand. These tendons are connected to the bones of the fingers and thumbs and extend up the arm.
The tendons in the thumb are protected by a covering called a tendon sheath. They are held close to the thumb bone by bands of tissue called pulleys. The tendon and its sheath need to glide smoothly through the pulleys to help bend and straighten the thumb.
Trigger thumb or stenosing tenosynovitis is when a child has difficulty bending or straightening their thumb. This condition may limit movement in the child’s hand, but it should not stop them from using it.
There are generally two types of trigger thumb in children
Acquired trigger thumb
Can develop in children and teenagers. It is caused by overuse, strain, or trauma.
They may have inflammation, swelling or bumps in the tendon or pulley of the thumb.
When the thumb moves, the tendon or pulley catches, clicks or “pops”. This can be painful, and the thumb may become bent.
Acquired trigger thumb is the same condition as acquired trigger finger.
Congenital trigger thumb
Found in babies, developing in the first few months of life with no known cause. The tendon in the thumb may grow faster than the pulley, meaning it cannot glide through the pulley easily.
Signs and symptoms
Babies may have the top joint of their thumb stuck in a bent position with no pain.
Older children may have symptoms in the thumb like:
- a popping or clicking sound when moving
- a feeling that it is “catching” when moving
- being stuck in a bent position
- a bump at the bottom, on the palm side
- pain and swelling, usually at the bottom
- stiffness.
Diagnosis
Trigger thumb can be diagnosed by your local doctor with a physical check.
Treatment
Most cases of trigger thumb in babies will get better on their own.
If your child does need treatment, it will depend on:
- how old your child is
- the type of trigger thumb they have
- how severe their symptoms are.
Treatment options can include:
- hand therapy and stretching
- re-learning how to use the thumb
- rest
- surgery to release the pulley in the thumb, letting it glide more smoothly.
Speak to your local doctor if you have any questions about treatment for trigger thumb.
Management
Paediatric trigger finger
Paediatric trigger finger is a rare condition. It is different from:
- congenital trigger thumb
- acquired trigger finger and thumb.
It is usually present at birth and may be associated with other disorders.
Speak to your local doctor if you have any concerns about paediatric trigger finger.
