Trigger Finger

This leaflet provides general information to help you understand trigger finger and the available treatment options.

Not everyone with a trigger finger needs surgery.

At the heart of my practice is Shared Decision-Making. Whether we pursue conservative management (Plan A) or surgical intervention (Plan B), the goal is to create a tailored treatment plan that aligns with your lifestyle, values, and functional goals.

The Anatomy of the Flexor Tendon

Tendons bend your fingers by sliding through a series of tunnels, relying on several structures working together.

How the Tendon Works

The tendon glides like a cable:

• A tendon runs along the front of each finger
• It slides through tunnels called pulleys
• This bends and straightens the finger

The Pulleys

Firm bands (pulleys) hold the tendon close to the bone so it can bend the finger smoothly and powerfully.

What Goes Wrong

• The tendon lining swells
• A small lump (nodule) forms
• It catches at the mouth of a pulley
• The finger clicks, snaps or locks

Where It Happens

• Usually at the A1 pulley in the palm
• At the base of the affected finger or thumb
• More than one digit can be affected
• Both hands can be involved

The Result

The finger catches or locks in a bent position, and can be painful or need the other hand to straighten it.

What Is Trigger Finger?

Trigger finger (stenosing tenosynovitis) causes a finger or thumb to catch, snap or pop when you straighten it. Inflammation thickens the tendon or forms a nodule that gets stuck at the entrance of its tunnel, so the finger clicks or locks in a bent position.

Who It Affects

It affects about 2 to 3 in 100 people:

• Women, about six times more often than men
• Most common in the 50s and 60s
• Frequent gripping or repetitive hand use

Linked Conditions

More common alongside:

• Diabetes — up to 1 in 10 are affected
• Rheumatoid arthritis
• An underactive thyroid
• Repetitive or forceful gripping

Symptoms & Examination

Symptoms

• A painful clicking or snapping when moving the finger
• Tenderness or a lump at the base of the finger
• The finger locking in a bent position

Examination

• The tender nodule is felt in the palm
• Catching is reproduced as the finger moves
• Locking and range of movement assessed

Diagnosis

• Usually a clinical diagnosis from examination
• No scans are needed in most cases

Treatment Options: A Shared Decision

I will discuss all available treatment options with you, explaining the benefits and risks of each. Your preferences, values, and lifestyle will be considered as we work together to create a treatment plan best suited to your needs — this shared decision-making process ensures you are fully informed and involved in your care.

Treatment Depends On

• How often the finger catches or locks
• How much pain and disruption it causes
• Your response to splints and injections
• Your preferences and goals

Many people improve with simple measures — mild cases can settle on their own, and doing nothing is always an option.

Plan A — Non-Surgical

• Activity: easing repetitive or forceful gripping
• Splints: a splint rests the finger, often overnight
• Anti-inflammatories: NSAID gels or tablets reduce swelling
• Injection: a steroid injection settles about two-thirds of cases

Plan B — Surgical

Considered when…

• Persistent Locking: the finger stays caught or locked
• Daily Life: catching limits hand use and grip
• Recurrence: symptoms return after injections
• Diabetes: injections are often less effective
• Approach: a small day-case release of the pulley
• The Procedure: known as Surgical Release, this small operation opens the tight A1 pulley so the tendon can glide freely, usually under local anaesthetic. A separate leaflet will be provided for the surgery.

Management Pathway

Questions You May Wish to Ask

• What treatments should I try first?
• How long should I try them for?
• What improvement can I expect?
• What happens if I don't have surgery?