Utku Gürhan

Hand and wrist

Trigger Finger: Locking Finger, Injections and Surgery

Written by: Asst. Prof. Dr. Utku GürhanLast updated:

In short

Trigger finger happens when the tendon that bends a finger catches at the entrance of a narrow tunnel in the palm, so the finger clicks, hurts or locks in a bent position. Mild cases often settle with activity changes and a splint, and many improve after a steroid injection into the tendon sheath. When injections fail or symptoms keep returning, a short day-case operation that widens the tunnel offers a lasting solution.

What is trigger finger?

The tendons that bend the fingers glide inside a tunnel that holds them close to the bone from the palm to the fingertip. The entrance of this tunnel in the palm is a tight band called the A1 pulley [1].

When this entrance thickens and narrows, the tendon cannot glide smoothly; the finger catches, clicks or stays bent as it moves. This is called trigger finger, and it can also affect the thumb [1]⁠[3].

Thickening at the tunnel entrance can also roughen the surface of the tendon. Each time the tendon tries to pass through the narrow section, friction increases and the catching becomes more noticeable [3].

What are the symptoms?

Symptoms range from mild catching to a finger that locks completely [1]⁠[2]⁠[3]:

  • Catching, clicking or a popping feeling when bending and straightening the finger
  • A finger that stays bent and needs the other hand to straighten it
  • Tenderness and sometimes a small lump at the base of the finger in the palm
  • Stiffness and pain that are often worse in the morning
  • Symptoms that increase with heavy use of the hand

What causes it, and who is at risk?

In most people there is no clear cause. It sometimes starts after a knock to the hand. Work activities rarely cause it on their own, although they may make the pain worse [2]⁠[3].

It is more common in people over 40, especially women aged 40 to 60, in people with diabetes or rheumatoid arthritis, and in those whose work involves frequent, forceful gripping [1]⁠[2]⁠[3].

How is it diagnosed?

Diagnosis is usually made from the history and examination. The doctor looks for tenderness and swelling in the palm and for catching as the finger moves. X-rays or other tests are not needed in most cases [1].

The doctor will also ask how long the symptoms have been present, which fingers are affected and whether there are related conditions such as diabetes or rheumatoid arthritis, as this helps guide treatment [1]⁠[3].

Non-surgical treatment

In mild cases, avoiding the movements that trigger symptoms, a night splint that keeps the finger straight, short-term painkillers and gentle stretching may be enough. In some people it settles without treatment [1]⁠[2]⁠[3]. The splint is usually worn at night; by keeping the finger straight it helps reduce morning locking and repeated friction on the tendon [1]⁠[3].

A steroid injection into the tendon sheath is a first-line treatment and relieves pain and catching in many patients [1]⁠[3]. If the first injection helped, it can be repeated when needed [1].

In some patients the effect of an injection wears off over time. In a randomised trial, injection was less successful than surgery at one year. The same trial also reported side effects after injection, such as a flare of pain for a few days and thinning of the fatty tissue under the skin at the injection site [5].

When is trigger finger surgery needed?

Surgery is recommended when symptoms persist despite splinting and injections, keep coming back, or the finger locks [1]⁠[2].

Through a small cut in the palm, the A1 pulley is opened to give the tendon more room. The operation is usually done under local anaesthetic as a day case [1]⁠[3]. Besides open surgery, a percutaneous technique, in which the pulley is released with a needle through the skin, may also be used; discuss with your doctor which method suits you [4].

A Cochrane review found that open surgery reduced the chance of symptoms returning compared with injection, although it caused more pain in the first week; the certainty of this evidence is low [4]. A randomised trial found surgery gave more lasting results, while noting that its rare complications can be more serious [5].

Recovery

The hand can usually be used for light tasks on the day of surgery, and pain often settles quickly. The scar may stay red and tender for a few weeks [3].

It can take several months for swelling and stiffness in the finger to settle completely. Recurrence after surgery is uncommon [1]⁠[3].

When should you see a doctor promptly?

Seek assessment without delay if you notice [1]⁠[2]⁠[5]:

  • A finger locked in a bent position that you cannot straighten
  • Persistent pain and catching that stop you doing daily tasks
  • Increasing redness, warmth, swelling or discharge after an injection or operation
  • New numbness in the finger after surgery

Frequently asked questions

+Why does my finger lock?

The most common cause of a finger that clicks, jumps or stays bent, often worse in the morning, is trigger finger. The tendon that bends the finger catches at the entrance of a narrow tunnel in the palm [1]⁠[2].

+Does trigger finger go away on its own?

Mild cases may improve with rest from aggravating activities and a splint, and some settle without treatment. If symptoms persist, a steroid injection or surgery is considered [1]⁠[2].

+How many steroid injections can you have for trigger finger?

If the first injection helped, it can be repeated when needed; the number is agreed with your doctor. If injections do not work or symptoms keep returning, surgery is a more lasting option [1]⁠[4]⁠[5].

+When can I use my hand after trigger finger surgery?

The hand can usually be used for light tasks on the day of surgery. The scar may be tender for a few weeks, and swelling and stiffness can take several months to settle fully [1]⁠[3].

+Is trigger finger more common with diabetes?

Yes. Diabetes is a known risk factor for trigger finger, although most people with trigger finger do not have diabetes [1]⁠[3].

Sources

  1. [1]Trigger Finger — American Academy of Orthopaedic Surgeons (OrthoInfo).
  2. [2]Trigger finger — NHS (nhs.uk), 2025.
  3. [3]Trigger Finger/Thumb — British Society for Surgery of the Hand (BSSH).
  4. [4]Surgery for trigger finger (Cochrane Review) — Cochrane Database of Systematic Reviews (Fiorini HJ, et al.), 2018.
  5. [5]Open Surgery Versus Ultrasound-Guided Corticosteroid Injection for Trigger Finger: A Randomized Controlled Trial With 1-Year Follow-up — The Journal of Hand Surgery (Hansen RL, et al.), 2017.

This article is general information and does not replace an examination or personal medical advice. In an emergency, go to the nearest emergency department.