Trigger Finger

What Is Trigger Finger?

Trigger finger, also known as stenosing tenosynovitis, is a common and treatable hand condition that affects the tendons responsible for finger or thumb bending. The flexor tendons glide through a tunnel made of pulleys and a smooth lining called the tenosynovium. If any part of this system becomes swollen or thickened—whether the tendon, the lining, or the pulley—friction increases, making it difficult for the tendon to move smoothly.

This can result in pain, stiffness, or the finger getting stuck in a bent position. It may pop or "trigger" when the finger is moved, especially after rest.

Causes

Trigger finger can occur due to:

• Thickening of the tendon or tendon lining

• Narrowing of the pulley the tendon passes through

It is more common in people with:

• Rheumatoid arthritis

• Gout

• Diabetes

• Jobs or hobbies involving repetitive gripping or pressure on the hands

In many cases, no clear cause is found.

Signs & Symptoms

• Pain at the base of the affected finger or thumb, especially with pressure or gripping

• Swelling or a lump (nodule) over the A1 pulley

• Stiffness or limited motion in bending or straightening the finger

• Clicking, popping, or locking with finger movement

• Symptoms may be worse in the morning or after periods of inactivity

In chronic cases, stiffness can become more severe due to ligament shortening or joint contracture.

Diagnosis

Trigger finger is usually diagnosed through:

• Physical examination

• Discussion of symptoms and history

• In rare or unclear cases, imaging such as ultrasound may be used

Additional testing is rarely necessary.

Treatment Options

Non-Surgical Treatment

The goal is to reduce swelling, eliminate catching or locking, and restore painless motion. Options include:

• Night splinting: Keeps the finger straight during sleep to reduce locking

• NSAIDs: Oral or topical anti-inflammatory medications (e.g., ibuprofen)

• Activity modification: Reducing repetitive or forceful gripping

• Corticosteroid injection: Reduces inflammation and may restore normal tendon motion

• Hand therapy: Exercises for joint mobility, tendon gliding, and edema control

Early treatment typically leads to better and faster results.

Surgical Treatment

If non-surgical methods are not successful, surgery may be recommended. Goals of surgery include:

• Releasing the A1 pulley to allow smooth tendon movement

• Removing thickened tendon lining (tenosynovectomy) if needed

• Reducing tendon bulk in resistant cases

Surgical technique options include:

• Open release

• Percutaneous (needle) release

• Performed under local anesthesia, often as an outpatient procedure

If possible, patients may be asked to actively move the finger during surgery to confirm successful release of symptoms.

Recovery & Outlook

• Mild tenderness may last for weeks to months

• Some stiffness may persist, especially if motion was limited before surgery

• Hand therapy is often recommended after surgery to regain full motion

• Most patients return to normal activities within weeks

Your hand surgeon will create a personalized treatment plan based on your symptoms, response to earlier treatment, and lifestyle needs.