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 [1][3]. Mild cases may respond to activity changes and a splint, and a steroid injection into the tendon sheath relieves symptoms in many patients [1][2][3]. If injections do not help or symptoms return, a short day-case operation that widens the tunnel is an option [1][2].
Why does the finger catch?
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 the entrance thickens and narrows the tendon cannot glide smoothly, so the finger catches, clicks or stays bent. The thumb can be affected too [1][3]. The thickening can also roughen the tendon surface; each time the tendon passes through the narrow section friction increases and the catching becomes more noticeable [3].
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
Who gets it?
In most people there is no clear cause. It sometimes starts after a knock to the hand. Work activities rarely cause it alone, although they may make the pain worse [2][3].
It is more common over the age of 40, especially in women aged 40 to 60, in people with diabetes or rheumatoid arthritis, and in those whose work involves frequent, forceful gripping [1][2][3].
Diagnosis
Diagnosis is usually made from the history and examination: we look 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].
We 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 options
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, and in some people it settles without treatment [1][2][3]. A night splint helps reduce morning locking and repeated friction on the tendon by keeping the finger straight [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, and the 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 surgery discussed?
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, usually 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; which method suits you is something to discuss with your surgeon [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].
After surgery
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 not to wait
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 I have?
- If the first injection helped, it can be repeated when needed, and 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].
At our clinic we decide on treatment together with you, after talking through how much the finger affects your daily tasks and what you expect.
Sources
- Trigger Finger. American Academy of Orthopaedic Surgeons (OrthoInfo), n.d.. orthoinfo.org
- Trigger finger. NHS (nhs.uk), 2025. nhs.uk
- Trigger Finger/Thumb. British Society for Surgery of the Hand (BSSH), n.d.. bssh.ac.uk
- Surgery for trigger finger (Cochrane Review). Cochrane Database of Systematic Reviews (Fiorini HJ, et al.), 2018. pubmed.ncbi.nlm.nih.gov
- 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. pubmed.ncbi.nlm.nih.gov
This article is general information and does not replace an examination or imaging. If you have symptoms, see a doctor.
More in this area
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- Thumb-side wrist pain: De Quervain's tenosynovitis
- Broken wrist: cast or surgery?
- Ganglion cyst: when does a lump on the wrist need treatment?
- Numbness and tingling in the hand and fingers: causes, what helps, who to see
- Cut tendons and nerves in the hand: when is it urgent?