Trigger Finger / Trigger Thumb
What is it?
Trigger finger is caused by thickening of either the flexor tendon or the pulley system that guides it along the finger. This most commonly affects the A1 pulley at the base of the finger in the palm. When the tendon becomes too large for the tunnel it runs through, it can momentarily catch, producing the characteristic clicking or locking sensation.
Symptoms and progression
Early symptoms may include soreness in the palm and occasional clicking. With time, locking becomes more frequent and painful, and the finger may stick in a bent position. Long‑standing cases can develop swelling along the tendon and secondary stiffness of the joints.
Diagnosis
Diagnosis is made clinically through examination, feeling the tendon move under the skin and reproducing symptoms. Imaging is rarely required unless the diagnosis is uncertain or there are atypical features.
Non‑surgical treatment
Initial management focuses on reducing inflammation and mechanical irritation. This includes activity modification, temporary splinting, oral anti‑inflammatory medication if appropriate, and corticosteroid injection into the tendon sheath. Many patients improve with injection, particularly when symptoms have been present for only a short time.
Surgery – trigger finger release
Surgery is recommended when conservative measures fail or when locking is frequent and disabling. The operation is usually performed under local anaesthetic or wrist block through a
small incision in the palm. The surgeon carefully identifies and divides the A1 pulley, immediately removing the mechanical obstruction and allowing the tendon to glide freely again. Mechanical symptoms typically resolve straight away. Light use of the hand is encouraged early, although tenderness in the palm and scar sensitivity are common for four to six weeks. In severe or long‑standing cases there may be lingering tightness due to inflammation further along the pulley system, which generally settles with time and structured hand therapy. Risks include infection, bleeding, nerve irritation, stiffness and—rarely—persistent triggering.
What does the rehabilitation/recovery involve?
To find out more about rehabilitation and recovery after surgery please see our Rehabilitation Protocols here.