Do You Have Trigger Finger? Signs, Diagnosis and Modern Treatments

Trigger finger, medically known as stenosing tenosynovitis, occurs when a flexor tendon becomes restricted as it passes through a tight section of its sheath at the base of the finger or thumb, known as the A1 pulley.

According to the NHS¹, this restriction prevents the tendon from gliding smoothly, leading to the characteristic clicking, catching or locking sensation during finger movement.

Trigger finger can affect any finger or the thumb and may involve more than one digit.

Symptoms often develop gradually and may worsen over time if left untreated. Common features include:

• Clicking or snapping during finger movement
• Catching or locking, sometimes requiring the other hand to straighten the finger
• Pain or tenderness at the base of the finger or thumb
• Stiffness, particularly first thing in the morning

In more advanced cases, the finger may become stuck in a bent position, significantly affecting hand function.

Trigger finger develops when irritation, thickening or inflammation affects the tendon or its surrounding sheath. Factors that may increase risk include:

• Repetitive gripping or forceful hand use
• Manual or tool-based occupations
• Diabetes or inflammatory conditions
• Previous hand injury or surgery
• Age-related tendon changes

The American Academy of Orthopaedic Surgeons² notes that trigger finger is more common in people who regularly perform repetitive hand movements, although it can also occur without a clear underlying cause.

Diagnosis is usually clinical and based on a combination of symptoms and examination findings. During assessment, a specialist will typically:

• Observe finger movement for clicking or locking
• Check for tenderness or thickening at the base of the finger
• Assess range of motion and overall hand function

Imaging tests are rarely required unless another hand condition is suspected.

Treatment depends on symptom severity, duration and how much the condition is affecting daily life. Early treatment often avoids the need for surgery.

Non-surgical treatment:

For mild or early cases, treatment may include:

• Activity modification
• Splinting to rest the affected finger
• Anti-inflammatory measures
• Hand therapy exercises

Steroid injection for trigger finger:

A corticosteroid injection into the tendon sheath can reduce inflammation and allow smoother tendon movement.

The British Society for Surgery of the Hand³ reports that steroid injections are often effective, particularly in early-stage trigger finger, and can resolve symptoms without surgery in many patients.

Surgical treatment for trigger finger:

Surgery may be recommended when symptoms persist despite non-surgical treatment, or when the finger regularly locks.

Trigger finger release is a minor procedure that releases the tight A1 pulley, allowing the tendon to glide freely again. This approach has a high success rate and reliably improves finger movement when conservative treatments fail.

In suitable cases, trigger finger release can be performed using a minimally invasive, ultrasound-guided technique.

Real-time ultrasound allows precise visualisation of the tendon, pulley and nearby nerves during the procedure. Compared with traditional open surgery, this approach may offer:

• A very small puncture rather than a larger incision
• Reduced tissue disruption and scarring
• Less post-procedure discomfort
• Faster return to everyday hand use
• An outpatient procedure under local anaesthetic
• Success rates comparable to open release

Learn more on our webpage: ultrasound-guided trigger finger release surgery

• After steroid injection: improvement may develop gradually over days to weeks
• After surgery: finger movement often improves immediately, with strength and comfort continuing to improve over the following weeks

Most patients return to normal daily activities relatively quickly, depending on their work and hand demands.