Trigger finger: symptoms, splints, injections and physio

A finger that catches, clicks or locks bent? What trigger finger is, why it happens, and how splints, exercises, injections and surgery compare.

You curl your fingers into a fist, then go to straighten them — and one finger stays bent. You straighten it with the other hand and it snaps open with a click. In the mornings it is worse, and there is a tender lump at the base of the finger in your palm.

That is trigger finger, known medically as stenosing tenosynovitis. It can affect any finger or the thumb (trigger thumb), and it is one of the most common hand problems seen by GPs, hand therapists and hand surgeons. The good news is that it usually responds well to treatment. This guide explains what is happening inside the finger, who gets it, and how the treatment options compare.

What is trigger finger?

The muscles that bend your fingers are in the forearm. They work through long tendons that run through the wrist and palm into each finger. To keep the tendons close to the bone as the finger bends, they pass under a series of tough bands called pulleys, like the guides on a fishing rod.

In trigger finger, the first pulley at the base of the finger — the A1 pulley — becomes thickened, and the tendon beneath it may develop a small swelling or nodule. The tendon then struggles to glide smoothly through the narrowed tunnel. It catches, and when enough force builds up it snaps through — the "trigger".

Who gets it?

A review in Current Reviews in Musculoskeletal Medicine describes trigger finger as common in the general population, and considerably more common in people with diabetes. Other links include:

• Women, especially in their 40s, 50s and 60s
• Diabetes — often in more than one finger, and sometimes less responsive to injections
• Rheumatoid arthritis, gout and thyroid conditions
• Carpal tunnel syndrome and De Quervain's tenosynovitis, which often occur alongside it
• Repeated forceful gripping — tools, gardening secateurs, heavy bags

In young children, a different form called paediatric trigger thumb occurs, where the thumb stays bent at the top joint. It is managed differently, and a GP or paediatric specialist should assess it.

Trigger thumb in adults

When the thumb is affected, the catching is usually felt at the base of the thumb on the palm side, and the thumb may lock bent at the top joint. It can make pinching, writing, opening jars and using a phone difficult. Splinting for a trigger thumb holds the thumb's base joint straight, and the treatment options are otherwise the same as for the fingers.

Symptoms

• Clicking, popping or catching when bending or straightening the finger
• The finger locking bent, needing help from the other hand to straighten
• Stiffness, especially first thing in the morning
• A tender lump at the base of the finger on the palm side
• Pain in the palm, sometimes spreading into the finger
• In longer-standing cases, being unable to fully bend or straighten the finger

Clinicians often grade trigger finger by severity, from pain and tenderness without catching, through catching that you can straighten yourself, to locking that needs the other hand, and finally a finger fixed in a bent position. Grading helps guide treatment.

“The earlier we see trigger finger, the more options there are. A finger that only clicks often settles with a splint and changes to how you grip; a finger that is locking may need an injection.”

— UpPlus Physiotherapy team

How it is diagnosed

Trigger finger is usually diagnosed from your story and a simple examination: feeling for the tender nodule over the A1 pulley and watching the finger catch as you make and release a fist. Scans are rarely needed, though ultrasound may be used if the picture is unclear or before an injection.

Treatment options

Evidence-based guidance for adult trigger digits, published in the Journal of Hand Surgery (European Volume), describes a stepped approach: conservative measures for mild cases, steroid injection as an effective treatment for many, and surgical release when other treatments have not worked or the finger is locked.

1. Change how you use the hand

• Reduce repeated hard gripping and pinching where you can.
• Use padded or larger handles on tools, gardening equipment and kitchen utensils.
• Avoid carrying heavy shopping bags hooked over the affected finger.
• Take breaks during gripping tasks.

2. Splinting

A small splint holds the base joint of the affected finger (or the thumb) in a straight position, limiting the tendon's movement through the tight pulley so the irritation can settle. It is usually worn for several weeks, often including at night. A systematic review of conservative management in the Journal of Hand Therapy found splinting can be an effective option, and an earlier study of splinting reported meaningful reductions in triggering. Splints work best for milder, more recent cases. A hand therapist or physio can make or fit one so it holds the right joint without stiffening the others.

3. Exercises and hands-on treatment

Gentle tendon gliding exercises, which move the tendons through their full range in a controlled way, are often used alongside splinting, along with soft-tissue treatment to the palm. The evidence for exercise alone is limited, so it is usually part of a combined approach rather than a stand-alone cure.

4. Steroid injection

A corticosteroid injection into the tendon sheath, given by a doctor, is a widely used and effective treatment for trigger finger. A Cochrane review found steroid with local anaesthetic worked better than local anaesthetic alone in the short term, though the number of trials was small. Many people get lasting relief from one injection, and a second injection is sometimes given if the first helps only partly. Success may be lower in people with diabetes or with multiple affected fingers. Our guides on cortisone injections and what to do after an injection cover these in more detail.

5. Surgery

If triggering keeps coming back, the finger is locked, or injections have not worked, a hand surgeon can release the tight A1 pulley. This is usually a short day procedure under local anaesthetic, done through a small cut in the palm (open release) or with a needle (percutaneous release). A Cochrane review found that surgery reduces the chance of triggering coming back compared with an injection. Hand therapy afterwards helps with movement, swelling and scar care.

Comparing the options

Many people move through these steps in order, but not everyone needs to. Someone with a finger locked bent for months may be better served going straight to a surgical opinion, while someone with occasional clicking may never need more than a splint. The right choice depends on how severe the triggering is, how long it has been present, your general health and what you need your hands for.

Exercises you can try

These should be comfortable. Do not force a locked finger straight.

• Tendon glides: move slowly through five positions — straight fingers, a "hook" fist, a full fist, a "tabletop", and a flat fist with straight fingertips. Hold each for 3 seconds, 5 times, two or three times a day.
• Warm-water movement: in the morning, gently open and close the hand in warm water to ease stiffness.
• Gentle finger stretch: rest the hand palm up on a table and gently ease the fingers straight with the other hand, holding for 20 seconds.

Recovery after surgery

• Movement of the finger usually starts within the first day or two, as advised by your surgeon.
• The wound is kept clean and dry until it heals, usually around 10–14 days.
• Tenderness in the palm when gripping can last several weeks to a few months.
• Hand therapy helps with stiffness, swelling, scar sensitivity and returning to grip strength.
• Contact your surgeon if the wound becomes red, hot, swollen or discharging, or if you have fever.

Everyday tips

• Choose tools with thick, cushioned handles; build up pens and cutlery with foam tubing.
• Use both hands for heavy lifting, and carry bags on the forearm or a shoulder.
• Wear padded gloves for gardening and gripping tasks.
• If you have diabetes, good blood sugar control is good for your hands too.

Myths about trigger finger

• "It's arthritis in the finger." It is a tendon and pulley problem, not a joint problem, although both can occur.
• "Cracking the finger straight helps." Forcing the finger can irritate it further.
• "Surgery is the only cure." Many people improve with splints or an injection.
• "It will go away if I ignore it." Some cases settle, but long-standing locking can leave the finger stiff.

When to see a physio or doctor

• A finger that clicks, catches or locks
• Morning stiffness and a tender lump at the base of a finger
• A finger that you cannot fully straighten or bend
• Several fingers affected, especially if you have diabetes

See a doctor promptly if a finger is red, hot and swollen, especially after a cut or puncture wound — this can be a tendon sheath infection, which is an emergency.

How UpPlus Physiotherapy helps

• Assessment of the hand, including checking for related problems like carpal tunnel syndrome
• Splint fitting and advice, and a home exercise programme
• Grip and tool modification advice for work and hobbies, including work-related hand problems
• Liaison with your GP if an injection or surgical opinion is appropriate
• Hand therapy after trigger finger release surgery

Read more about trigger finger, De Quervain's tenosynovitis, thumb arthritis and our carpal tunnel syndrome guide.

Finding a physio near me for trigger finger

When searching for the best physio or hand therapist for trigger finger, look for someone who grades the problem properly, fits a splint that holds the right joint, gives you practical grip advice, and knows when an injection or surgical opinion is the better path.

Our clinic is at 177 Trimmer Parade, Seaton, a short drive from Woodville, Findon, West Lakes, Grange and Kilkenny. No referral is needed, and you can claim on the spot with private health cover.

If a finger is clicking or locking, our physiotherapists can assess it and help you decide on the right next step. Book online or call 0403 907 587.

This article is general information, not a diagnosis or a substitute for an individual assessment. If you are unsure about your symptoms, see a health professional.