Hand & Finger Conditions
Trigger
Finger
Trigger finger involves symptoms of catching or locking of the fingers or thumb. The flexor tendons that bend our fingers toward the palm are held close to the underlying bones by ligaments called pulleys — and when the A1 pulley becomes tight, the tendon cannot glide smoothly.
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Overview
What Is Trigger Finger?
Trigger finger involves symptoms of catching or locking of the fingers or thumb. The tendons which flex our fingers — bending them toward the palm — are held close to the underlying bones by ligaments called pulleys.
Non-inflammatory trigger finger results when the A1 pulley becomes tight, and the flexor tendon cannot glide smoothly. This leads to catching of the fingers as they attempt to move from a flexed (closed) to an extended (open) position.
How the Pulley System Works
The flexor tendons travel through a series of pulleys that keep them positioned against the bones of the finger. The first of these — the A1 pulley — sits at the base of the finger. When it thickens or tightens, the tendon can no longer pass through smoothly, and the finger begins to catch as it straightens.
What Patients Notice
- Catching or clicking as the finger bends or straightens
- A finger that has to be pulled open after closing
- A finger locked in a flexed (closed) position
- Pain or tenderness at the base of the finger or thumb
- A tender bump or nodule in the palm at the base of the finger
- Stiffness, especially in the morning
When to Seek Evaluation
A finger that catches, locks or must be pulled open is worth evaluating. Early evaluation can confirm whether the A1 pulley is the source of the problem and help you understand which treatment options may be appropriate for your situation.
Request an AppointmentTreatment Options
Non-Surgical Treatment
A non-surgical treatment option commonly utilized involves cortisone injection into the area of constriction. Injection is often considered before surgery, and many patients respond well to it.
Cortisone Injection
A non-surgical treatment option commonly utilized involves cortisone injection into the area of constriction — the A1 pulley at the base of the finger. This is often the first step when a finger is catching or locking, and it is performed in the office.
Activity & Symptom Management
Reducing repetitive gripping and prolonged finger flexion may help lessen irritation around the pulley. Splinting or taping the affected finger in a straighter position can reduce the catching motion while symptoms settle.
Discussion of Risks & Benefits
Non-operative treatment also carries risks and benefits which should be discussed with your treating physician. The right choice depends on your symptoms, how long they have been present and how much they affect your daily activities.
Non-operative treatment also carries risks and benefits which should be discussed with your treating physician.
Surgical Treatment
Surgical Release of the A1 Pulley
When nonoperative treatment remains unsuccessful, surgical release of the area of constriction may provide relief. The goal of surgery is to open the tight A1 pulley so the flexor tendon can glide smoothly again.
Release of the pulley allows the tendon to move without catching as the finger bends and straightens. As with any hand surgery, outcomes vary and risks and benefits should be discussed in detail with your treating physician.
Discussing Risks & Benefits
Outcomes after hand surgery vary and risks and benefits should be discussed in detail with your treating physician. Non-operative treatment also carries risks and benefits which should be discussed with your treating physician.
Surgical Considerations
- Surgical release of the area of constriction (the A1 pulley)
- Considered when nonoperative treatment remains unsuccessful
- Aims to allow the flexor tendon to glide smoothly
- Discussed with your treating physician in detail
Finger Catching or Locking?
An evaluation can confirm whether the A1 pulley is the cause of your symptoms and help determine whether injection, surgical release or another approach is right for you.
Request an AppointmentCommon Questions
Trigger Finger FAQs
What is trigger finger?+
Trigger finger involves symptoms of catching or locking of the fingers or thumb. The tendons which flex our fingers are held close to the underlying bones by ligaments called pulleys. Non-inflammatory trigger finger results when the A1 pulley becomes tight, and the flexor tendon cannot glide smoothly.
Why does my finger get stuck?+
Because the A1 pulley becomes tight, the flexor tendon cannot glide smoothly, which leads to catching of the fingers as they attempt to move from a flexed (closed) to an extended (open) position. Occasionally, the finger may be stuck in a flexed position and has to be pulled open. Rarely, the finger may be locked in a flexed position and unable to be pulled open.
Can trigger finger be treated without surgery?+
Yes. A non-surgical treatment option commonly utilized involves cortisone injection into the area of constriction. Non-operative treatment also carries risks and benefits which should be discussed with your treating physician.
When is surgery considered for trigger finger?+
When nonoperative treatment remains unsuccessful, surgical release of the area of constriction may provide relief. Outcomes after hand surgery vary and risks and benefits should be discussed in detail with your treating physician.
Read more about when trigger finger needs treatment or explore other hand and finger conditions.
Precision Hand and Orthopedic Surgery
Is a Finger Catching or Locking?
If a finger or thumb is catching, clicking or getting stuck, an evaluation with Tanay Amin, MD, FAAOS can help determine whether trigger finger is the cause and what treatment is right for you.
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Disclaimer: This information is not intended to convey, substitute or supplant any medical advice. In order to establish a treating relationship, please schedule and complete your visits with a licensed physician.
Copyright 12/9/2021 Tanay Amin, MD. Do not copy, distribute, or publish this article. Please contact Precision Hand and Orthopedic Surgery PLLC with regards to any inquiries or corrections.