Trigger finger

Causes and risk factors

Thickening of the tendon or narrowing at the A1 pulley makes gliding difficult. Repeated forceful gripping can aggravate symptoms. Diabetes and inflammatory rheumatic disease increase risk, although there is often no clear cause. The condition differs from Dupuytren's contracture or a locked joint. A finger that no longer moves freely does not automatically mean a torn tendon.

Typical symptoms

Tenderness in the palm at the finger base and a noticeable snap on straightening are typical. The finger is often stiffer in the morning. In advanced cases, the other hand is needed to straighten it, or it stays bent. Repeated forceful pulling is unhelpful. Acute marked redness and swelling with severe pain on movement are not typical of every ordinary trigger finger and need prompt examination.

Diagnosis

The diagnosis can often be made from history and examination. We feel along the tendon, check the catching and assess joint movement. We also ask whether several fingers are affected and whether diabetes or inflammatory disease is present. Further imaging is usually unnecessary for typical findings. Ultrasound or other tests may help with an unclear cause, unusual swelling or suspected alternative conditions.

Non-surgical treatment

Initially, adjusted gripping activities, temporary splinting and suitable pain relief may help. A corticosteroid injection around the tendon sheath is an option in selected cases. We discuss benefits, risks and possible temporary blood sugar changes in people with diabetes. Success is not guaranteed. Persistent locking or increasing restriction should prompt joint reassessment of treatment.

Surgical options

For persistent or severe triggering, the constricting pulley may be surgically divided. This gives the flexor tendon more room; the tendon itself is not cut. Pulley release is among our selected outpatient procedures at the external surgical centre. Anaesthesia, risks and expected recovery are explained beforehand. Longstanding joint stiffness may remain even after the mechanical narrowing has been relieved.

Aftercare and rehabilitation

Early guided finger movement supports tendon gliding, while the wound and scar are initially protected from pressure and heavy loading. Wound checks and hand therapy where appropriate support recovery. Swelling and tenderness may last longer than the catching. Return to forceful gripping and manual work is tailored individually. Increasing redness, new loss of sensation or worsening pain should be reviewed promptly rather than assumed to be normal healing.

Common questions

Arrange a consultation

We discuss which treatment is suitable for your findings and which procedures are available within our outpatient service during a personal consultation. Outpatient operations take place at an external surgical centre.

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