Trigger finger
What is Trigger finger?
Trigger finger is a condition where a finger or thumb tendon catches as it passes through the A1 pulley in the palm. The tendon may become thickened or inflamed, causing painful clicking or locking.
Common symptoms
Symptoms include catching, clicking, pain at the base of the finger, morning stiffness, locking in flexion and needing to use the other hand to straighten the finger. It may affect one or multiple digits.
Diagnosis and imaging
Diagnosis is usually clinical. Examination identifies tenderness at the A1 pulley and observes triggering. Imaging is rarely required unless symptoms are atypical or another condition is suspected.
Non-surgical treatment
Treatment includes activity modification, splinting, hand therapy and corticosteroid injection. Injections are often effective, although recurrence is more common in some patients, including those with diabetes.
Surgical treatment
Surgical release is considered for persistent locking, failed injections, recurrent symptoms or severe triggering. The A1 pulley is released to allow smooth tendon gliding.
Recovery and follow-up
After release, finger motion starts early to prevent stiffness. Tenderness in the palm can persist for several weeks, while grip strength and comfort gradually improve.
Trigger finger FAQs
Why does my finger lock in the morning?
Fluid and tendon swelling can be worse after rest, making the tendon catch more as the finger first starts moving.
How is trigger finger diagnosed?
Diagnosis starts with a focused history and examination, then uses imaging selectively to confirm the pattern of injury, exclude related problems and plan treatment accurately.
Do steroid injections work for trigger finger?
They often work well, especially for early cases. Recurrence can occur, and some patients ultimately choose surgery.
Will I need surgery for trigger finger?
Many patients improve without surgery. Surgery is considered when symptoms remain limiting despite appropriate non-surgical care, when there is significant structural damage, or when delay may compromise function.
Can trigger finger affect the thumb?
Yes. Trigger thumb is the same process affecting the thumb flexor tendon.
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