Thumb base arthritis
Trigger Finger (Stenosing Tenosynovitis)
What is Trigger Finger?
Trigger finger is a condition that affects the movement of one or more fingers, causing them to catch, click, or lock when bent or straightened. This happens when the flexor tendon has difficulty gliding smoothly through its surrounding sheath due to thickening or irritation of the sheath itself (called the A1 pulley).
It most commonly affects the ring and middle fingers, though the thumb and other fingers can also be involved. The condition may affect just one digit or multiple fingers and can occur in one or both hands.
Causes and Risk Factors
Trigger finger develops when the flexor tendon sheath becomes thickened or irritated, narrowing the space through which the tendon moves. This interferes with normal tendon gliding and may cause it to catch or lock.
Risk factors include:
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Diabetes
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Rheumatoid arthritis or other inflammatory conditions
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Female gender
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Age between 40 and 60
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Occupations or hobbies that involve frequent hand use
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Previous hand trauma or surgery
Symptoms
Symptoms can range from mild to severe and may include:
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A clicking or catching sensation during finger movement
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Stiffness in the affected finger, often worse in the morning
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Pain or tenderness at the base of the finger or thumb
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A palpable lump in the palm at the base of the affected finger
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The finger may lock in a bent position and then suddenly straighten
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In more advanced cases, the finger may become stuck in a bent or straight position and require assistance to move
It is important to note that not all cases involve full locking—many patients experience only clicking or catching without the finger becoming stuck.
Diagnosis & Investigation
Trigger finger is typically diagnosed during a consultation based on clinical evaluation. No imaging is usually required.
During your visit:
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The surgeon will take a detailed medical history, including the duration of symptoms, which fingers are affected, and any underlying health conditions (such as diabetes or arthritis).
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A physical examination of the hand will be performed to assess for:
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Pain or tenderness at the base of the affected finger
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Catching or triggering on movement
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Presence of nodules or swelling
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Any loss of motion or locking
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In some complex cases, an ultrasound may be used to assess tendon movement, but this is rarely necessary.
Non-Surgical Treatment
The mainstay of non-surgical treatment for trigger finger is a corticosteroid injection into the tendon sheath. This reduces inflammation, allowing the tendon to glide more freely.
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Steroid injection is quick, typically performed in the clinic, and is effective in many cases—particularly when symptoms are caught early.
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Relief is often felt within days to a few weeks.
Other conservative measures, such as:
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Splinting
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Activity modification
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Anti-inflammatory medications (NSAIDs)
Surgical Treatment
If steroid injections are not effective or the finger is severely affected or locked, surgical release is recommended.
Trigger Finger Release Surgery
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A short outpatient procedure under local anaesthetic
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A small incision is made at the base of the affected finger
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The A1 pulley (tendon sheath) is carefully released to allow full, unrestricted tendon movement
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The surgeon will confirm during the procedure that the tendon moves freely and is no longer catching
Recovery
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Most patients regain finger motion immediately after surgery
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Light activities can resume within a few days
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Full recovery and return to normal hand function is usually achieved within 2–4 weeks
Risks
Complications are uncommon but may include:
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Infection
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Tenderness or sensitivity at the incision site
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Scar formation
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Incomplete release (rare)
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Injury to nearby nerves or vessels (rare)
When to See One of Our Hand Specialists
When to see on of our Hand Specialistse
You may wish to consult a hand specialist if:
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You notice persistent clicking, catching, or locking
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Symptoms interfere with everyday activities like gripping or writing
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Your finger feels painful or stiff and is not improving