Trigger finger, also called stenosing tenosynovitis, is a common hand condition that impairs overall hand function. Patients with trigger finger have inflammation or thickening of the tendon sheath, the slick lining that allows the finger tendon to glide through finger pulleys. When this sheath is inflamed or narrowed, it makes it difficult for the tendon to move freely through the pulley. This increased resistance of the tendon causes a catching, popping, or clicking sensation in the affected finger.

Trigger Finger Symptoms

Symptoms of trigger finger are usually more pronounced in the morning or after periods of inactivity. Sometimes a patient’s finger will feel “stuck” or locked in a certain position, and become painful and hard to move. Other common symptoms include:

• Sore lump at the base of the finger on the palmar side of the hand
• Popping or clicking sensation in the finger
• Pain when moving the finger
• Finger locking

Trigger Finger Diagnosis

Trigger finger is a condition where the A1 pulley, located in a patient’s finger, becomes inflamed and thickened. This inflammation causes difficulty for the flexor tendon to move through the pulley as the finger bends. Over time, the flexor tendon may develop an inflamed nodule on its surface, worsening the condition. As the finger bends, the thickened nodule passes through the tight pulley, resulting in a catching or popping sensation that is often painful. In severe cases, the digit may become locked in a bent position, requiring manual straightening by the patient using their other hand.

During your examination, we’ll look for tenderness in the affected finger, particularly over the A1 pulley and the tendon sheath. We’ll also look for signs of swelling or thickening of the tendon sheath and nodules. The telltale sign of trigger finger, however, is a catching sensation when the finger is straightened or bent.

Trigger Finger Treatment Options

Not all cases of trigger finger require surgery. In fact, many patients can successfully relieve symptoms with non-surgical forms of treatment:

Rest: One of the first treatment options we recommend for trigger finger is rest. We usually recommend splinting the affected hand to limit motion. Each time the tendon catches, it produces more inflammation and swelling in the tendon sheath – exacerbating the problem. Trigger finger will continue to get worse with overuse of the finger. Over time, resting the hand allows swelling around the flexor tendon and tendon sheath to decrease, allowing for smoother tendon gliding.

Over-the-counter Medications: Taking an anti-inflammatory medication, such as Ibuprofen, can also help reduce swelling.

Steroid Injections: Corticosteroid injections around the tendon and A1 pulley often help relieve trigger finger symptoms. If symptoms come back after the first injection, we may try a second injection. Surgery is often recommended if two injections don’t resolve trigger finger symptoms.

Stretching: Gentle stretches may help improve range of motion in the affected finger.

Trigger Finger Release Surgery

If non-surgical treatment approaches are ineffective, then your hand surgeon may recommend trigger finger release surgery. During the procedure, we relieve swelling in the tendon sheath by opening the A1 pulley at the base of the finger. This allows the tendon to glide more freely. The outpatient procedure is performed at our ambulatory surgery center in Flagstaff, AZ, and patients can go home after their trigger finger release. The procedure is usually done awake under a local anesthetic or nerve block.

Medical Review: This procedural information has been medically reviewed by plastic and reconstructive surgeon, Brian A. Cripe, M.D.