Trigger finger is a narrowing of the sheath through which the finger's flexor tendon glides at its entrance in the palm, so the tendon can no longer slide freely. The result is a finger that clicks or catches when it opens and then snaps free, together with pain and tenderness at the base of the finger. Symptoms are usually worst in the morning, more than one finger may be involved, and the thumb is among the most commonly affected. In most people the cause is not an injury but a change in the sheath itself. It is more common in those with diabetes, an underactive thyroid or rheumatoid disease, and it may appear during pregnancy. It often coexists with other hand conditions such as De Quervain's tenosynovitis of the thumb tendons or nerve compression in the carpal tunnel, which is why the doctor examines the whole hand rather than the complaining finger alone. Treatment starts with the simplest measure that works: activity modification, a night splint that stops the finger curling during sleep, and gentle gliding exercises. If that is not enough, an injection around the sheath is a common option that reduces the narrowing and restores gliding in many patients. Surgical release is performed under local anaesthesia through a small palm incision to open the tight part of the sheath, and is offered when catching keeps returning or the finger has become locked. The limits must be clear. An injection may give lasting relief but cannot guarantee that the problem will not return, and surgical release opens the catching but does not undo joint stiffness that built up over months of neglect, nor restore a tendon to its former state. Most importantly, surgery does not treat numbness. If you have tingling in the fingertips or weakness in the thumb grip, the problem may lie in the **carpal tunnel**, which often improves without surgery in its early stages, while **long delay leaves permanent weakness and muscle wasting that no later operation can restore**. Suitability for any option is decided by clinical examination, not by reading a page.
Procedure steps
- 1
Examining the whole hand and defining the cause
The doctor palpates the base of the finger and watches you open and close the hand to see the catching, then checks the thumb, wrist, sensation and grip strength, and asks about diabetes, thyroid disease and joint disorders.
- 2
Splinting and activity modification
A night splint worn for some weeks prevents the finger from curling during sleep, alongside less repetitive gripping, avoiding tools with thin handles, and gentle gliding exercises that keep the joint supple.
- 3
Injection around the tendon sheath
After skin cleaning, an anti-inflammatory medicine is injected into the space around the sheath rather than into the tendon; the effect may take days to appear. A second attempt is sometimes reasonable, at the doctor's discretion.
- 4
Surgical release under local anaesthesia
A small area of the palm is anaesthetised and the tight part of the sheath is divided through a short incision. You are asked to move the finger on the table to confirm that the catching has gone before the wound is closed.
- 5
Early movement and follow-up
Finger movement begins the same day to prevent adhesions and stiffness, with graded exercises and elevation to reduce swelling, plus a review to remove stitches and reassess grip and sensation.
Before the procedure
Tell your doctor when the catching started and which fingers are affected, whether there is numbness or grip weakness, and whether you have diabetes, thyroid disease or arthritis, since these change both the plan and the follow-up. List every medicine and supplement you take, especially blood thinners, and any allergy to local anaesthetic or skin antiseptics. Remove rings before the appointment, because swelling can make them difficult to take off later, and trim your nails and wash the hand well. Fasting is usually unnecessary for an injection or a release under local anaesthesia unless you are specifically told otherwise. Arrange help with tasks that need a strong grip for a few days afterwards, never stop a prescribed medicine on your own, and ask when your exercises should begin.
After the procedure
Keep the hand raised above heart level during the first days to limit swelling, and move the fingers regularly from the same day, because early movement is what prevents stiffness. Keep the wound clean and dry until your doctor allows normal showering, and avoid heavy lifting, forceful gripping and vibrating tools for two to four weeks according to your surgeon's advice. Mild tenderness in the palm may persist for weeks and is expected. **Seek care immediately if you develop fever, spreading redness, hot swelling or discharge from the wound, escalating pain that does not respond to analgesia, or new numbness or thumb weakness.** **If a hand injury is accompanied by loss of sensation, a pale cold finger, or inability to move the finger, this is an emergency: go to hospital at once rather than waiting for an appointment.**
Expected duration
An assessment visit usually takes 15 to 25 minutes. An injection around the sheath commonly takes 5 to 15 minutes with a short wait afterwards. Surgical release under local anaesthesia usually takes 15 to 30 minutes and you go home the same day. Light activity resumes within days, while full grip strength commonly needs two to six weeks depending on the case and occupation.
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