Trigger Finger and Dupuytren Contracture

How is trigger finger different from Dupuytren contracture?

As a reader of this website, you probably have a good idea about Dupuytren contracture, but not a clear idea of what is called a trigger finger.

Trigger finger defined

A trigger finger is a mildly to moderately painful condition in which any finger or thumb becomes suddenly stopped or blocked during finger movement while in a flexed or curled position.  In severe cases, the trigger finger cannot be voluntarily straightened; in less severe cases of trigger finger the locked finger can only be straightened or unlocked with deliberate effort.  The trigger finger name comes from the sudden release and snapping or popping sensation that occurs when the finger finally does straighten – much like the trigger of a gun that suddenly releases with a clicking sound.

To understand what happens when a trigger finger locks while it is flexed, it is necessary to understand a bit of hand anatomy.  Those muscles that bend and straighten the fingers are not located in the hands – they are located in the forearms.  These forearm muscles can operate the fingers because they are connected to the fingers by long tendons that extend to each fingertip.  When these tendons pass through the palm on the way to the fingers, they are encased or covered with a fibrous sheathe (like a sword is kept in a sheath).  The sheath protects the tendon, guides the tendon where it passes between bones, and keeps it lubricated to make movement smoother and easier.

A trigger finger develops when there is a narrowing or constriction in the tendon sheath and a nodule develops as a result of overuse or injury.  When the finger is flexed, causing the nodule on the tendon to pass through the narrowed part of the sheath, the nodule or thickened are will catch or resist at that same point in the flexed position that brings the narrow area and the nodule together.  The sudden snap release of the trigger finger occurs when the nodule or thickening suddenly passes the restricted portion and can again freely slide past it.

The cause of trigger finger is often related to a large sudden injury or small repeated injury or overuse of the hand, or as a result of a degenerative process as with aging or disease.

Most often a trigger finger will act up in the morning, or after a period of rest after heavy hand exertion.  The finger will suddenly catch or lock while in the flexed or bent position and then with a little effort to straighten the finger it will suddenly straighten accompanied by a clicking sensation.  A trigger finger occurs more often in the dominant use hand, since this is the one most subject to overuse and injury, and most often develops in the thumb, middle or ring finger. More than one finger can be affected at a time, as well as both hands can have a trigger finger.

Trigger finger different from Dupuytren’s contracture

Trigger finger is not the same as Dupuytren’s contracture; they are only similar in that both involve finger flexion.  Dupuytren contracture is a condition in which thickening and shortening of the connective tissue occurs in the palm of the hand,  that resemble cords and nodules, in which there is some finger flexion as a result.    Both Dupuytren contracture and trigger finger can occur at the same time in the same hand, since the soft tissue changes of the former can favor development of the later.

In the experience of DCI working with this problem since 2002, we find that many of our Dupuytren contracture treatment ideas can help to reduce or eliminate a chronic trigger finger problem.

12 thoughts on “Trigger Finger and Dupuytren Contracture

  1. Jasper Whiteside says:

    Trigger finger is one of those things that sounds like it is caused by pulling a trigger too much. Thanks to this article, I have learned that it is similar to tennis elbow. It can be developed without ever pulling a trigger or swinging a racket. I also have learned that it is different from Dupuytren’s contracture, which I thought was the medical terminology for it.

  2. Dr.Herazy says:

    Greetings Jasper,

    Yes, the term “trigger finger” is more about what the condition feels like to the person who has it rather that how it is caused. And it is certainly not always a part of having Dupuytren’s contracture, although a person can develop a trigger finger because of having Dupuytren’s contracture. TRH

  3. Mark Bernhardt says:

    I have had two successful operations (one on each hand ) for Dupuytren’s contracture.
    However I have recently developed trigger finger in my middle finger of my left hand it occurs when I awake in the morning, so I presume this could be a result of my Dupytrens!

  4. Dr.Herazy says:

    Greetings Mark,

    So glad to learn you believe your two Dupuytren’s contracture surgeries were successful. How long ago did each hand surgery happen?

    I ask that question for a reason. Most of the time when a person says he has a good Dupuytren’s contracture hand surgery it is because it was done recently (within the last few months to a year) and complications like numbness, tingling, loss of movement, or recurrence of Dupuytren’s contracture has not yet appeared. So much of the time the evaluation of the surgical outcome is based on the idea the hand lump or cord was removed, and the fingers might be moving better so the assumption is made that the surgery was a huge success. I am always a lot more interested, and surprised, if someone can tell me they had Dupuytren’s contracture surgery five or ten years ago and they are enjoying full finger and hand movement and strength, no loss of sensation, no pain, and most of all no recurrence of their Dupuytren’s contracture.

    For most people who undergo Dupuytren’s contracture surgery, from my perspective, the story is not so good. They either realize within a few days after hand surgery that something is wrong and the surgery went badly because they are in more pain, or have numbness they did not have before, or have no more and perhaps even less finger movement than before the surgery, or they begin to see within a few months many of these symptoms of pain, numbness and loss of finger movement crop up.

    I sincerely hope none of this is true for you, and you have had a fantastic outcome from your hand surgery and your Dupuytren’s contracture never recurs. You, of course, would be the exception. All honest surgeons have to admit that recurrence happens eventually (within a few months to within a few years on average, sometimes going as long as ten years or more in some lucky folks) but it always eventually happens. Surgery for Dupuytren’s contracture is a stop-gap measure that gives temporary relief from the palm lump and cord, with many people a year or so. I recently spoke to a woman who is getting ready for her 4th Dupuytren’s contracture surgery in seven years, and the surgeon has told her this will be the last one before they will do amputation.

    Yes, your trigger is probably related to your Dupuytren’s contracture. This suggests that perhaps either your surgery was not as successful as you assume, or it is the first sign of recurrence of your hand problem. I suggest you contact another surgeon for an evaluation of what might be going on in your situation. Good luck to you and your Dupuytren’s contracture. TRH

  5. Tom vinci says:

    Thank you. This has been very informative. My dad lived with Dupuytren’s contracture for many years. My 2 older brothers also have it, but my Dupuytrens is more advanced. I have had 5 trigger surgeries, right carpal surgery, and right trapeziectomy, and now the 4th digits on both hands are involved. Will triggering after surgery return?
    Any way to avoid trigger surgery?
    What is best/latest Dupuytren’s contracture treatment?
    Many thanks.
    Tom Vinci

  6. 88TRH88 says:

    Greetings Tom,

    Your report of multiple hand surgeries and worsening condition of your Dupuytren’s contracture is common. The fact that you have a strong genetic tendency to DC means that the tissue in your palm when injured or disturbed will respond with excess fibrin and collagen. Having more hand surgery will only provoke a stronger Dupuytren’s contracture response.

    The British Dupuytren’s Contracture Society reported in November 2019 that the manufacturer of Xiaflex is discontinuing the sale of that drug to most parts of the world, except the US. They have not explained their actions. I suspect it is due to problems with drug reactions and side effects.

    My opinion is that the best Dupuytren’s contracture treatment is the oldest one. Giving your own body the best opportunity to heal and repair to the best of its ability is the obvious choice. The Dupuytren’s Contracture Institute receives eight to 10 reports of moderate to marked success over DC using our alternative methods for every one report of failure. Please review the information on this website for details. TRH

  7. Jeanne says:

    Had surgery for Trigger Thumb several years ago, not related to Dupuytren’s contracture. The surgeon told me that the fingers will develop into trigger finger. Last year I started waking up with the ring finger on both hands bent over and in pain. They clicked when I straighten them. The only way I found relief was to wear tight gloves when I sleep. Later I found that using sticky tape to individually wrap ring fingers helped during the day time. With pain in other fingers and thumbs I started wrapping them too. The fingers have gotten better and the amount of pain has lessened. Sometimes other fingers next to the ring finger and the tendon in palm hurt. Also rubbed tendons and used squeeze balls to encourage movement and get relief. The sticky tape has helped a lot and I now wake up without the pain or bent fingers. I have not wanted to have injections or do surgery so healing has taken a long time.

    My question is “Can my hands heal totally without injections or surgery? Am I doing the best things I can to assist the healing?” I do have less pain now, although I have issues using can opener or squeezing toothpaste. It has gotten better but not totally yet.

  8. 88TRH88 says:

    Greetings Jeanne,

    You clearly do not have Dupuytren’s contracture developing in your other fingers since you do not have nodule formation in your palms. Your finger flexion, while being a characteristic of Dupuytren’s contracture, is likely caused by shortening of muscles, ligaments or tendons secondary to a low grade tissue irritation in your hands. All of this could be causing reduced drainage and circulation of the lymph fluid in your hands, resulting in the clicking of the tendons of your fingers.

    Assuming your surgeon has done a good examination of your hands, and ruled out any serious pathology, I suggest you have an experienced massage therapist who specializes in soft tissue problems look you over. My suspicion is that you have a chronic myofascitis higher up (elbows or shoulders) that is interfering with the lymphatic drainage of your hands. While in practice I encountered many hundreds of people like you with similar strange complaints. These quirky conditions defied conventional thinking that was only looking for gross outright tissue disease, and is simply a matter of something being “stuck” in the complex machinery of the body. Check it out. Good luck. TRH

  9. George says:

    I have several large nodules In the palm of my left hand in line with my smallest two fingers that are getting larger. Doctors have diagnosed as Dupuytren’s contracture, but now I’m developing trigger finger in my small finger. Are they related? And what should I be doing?

  10. 88TRH88 says:

    Greetings George,

    Yes, Dupuytren’s contracture and trigger finger can be related. Trigger finger sometimes develops in a case of Dupuytren’s contracture, rather commonly. This happens because of the internal stress and irritation that can happen as the palm nodule develops. This causes the sheath of tissue around each finger tendon to become inflamed, resulting in the little catching and clicking that is known as trigger finger.

    What can you do about it? Do your best to help your body heal your Dupuytren’s contracture? Go to the home page. Find that large button that says, “New customer.” Click on it, and figure out which plan you should use to help your body do a better job of eliminating the DC naturally. We get 8-10 reports of moderate to marked improvement of Dupuytren’s contracture, up to and including complete healing and elimination, for every one report of failure. You owe it to your self to at least try for 3-4 months to see if your body can do it. By the way, if you are like others, your trigger finger will disappear as your DC improves.

    Let me know if I can help you get started. TRH

  11. terry mcgorrigan says:

    My wife has been diagnosed with osteoarthritis in the left thumb base and triggering of the ring finger of the left hand with palm Dupuytren’s contracture band. A consultant orthopaedic surgeon states that “power grip” in the left hand would deal with the problems. What is “power grip”? Is it feasible that my wife could have power grip? Regards Terry

  12. Dr. Herazy says:

    Greetings Terry,

    Not exactly sure if you understood what the orthopedic surgeon was saying about “power grip” in regard to your wife’s condition; you might have been confused with some of the technical terminology. There are several commercial exercise devices that use the term “power grip,” and this might be what you were told. However, there is another way this term is sometimes used.

    Broadly, a “power grip” is a sports physiology or kinesiology term that describes a type of gripping movement of the hand in sports or during intense work activities. In these situations the hands and fingers work as a unit to deliver strong and intense contraction, without need or regard for much precision; short duration intense work (hanging on for dear life).

    Specifically, in regard to Dupuytren’s contracture, I have long cautioned people, in all walks of life, to avoid the use of a power grip approach to what they do in their lives. People make themselves prone to Dupuytren’s contracture when they habitually use their hands and forearm muscles aggressively, forcefully and with intensity throughout their day. It is the way they live their lives. Pianists, violinists, potters at the wheel, typists, horse riders, pilots are all prone to over-working their hands and forearms while doing their chosen activities. They often resort to a power grip approach while trying to achieve their own levels of perfection. All these occupations are predisposed to higher rates of Dupuytren’s contracture for this reason, I feel.

    Perhaps this is what was told to you by the orthopedic surgeon in regard to your wife’s Dupuytren’s contracture. Too bad you did not ask the doctor to explain a little better. TRH

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