Trigger Finger

This one is usually diagnosed in the room. Your clinician talks through your symptoms and examines your hand, and X-rays or other tests typically aren't needed ⁶. The examination looks for tenderness over the tendon's tunnel in your palm, thickening or swelling at the base of the finger or thumb, and a click or catch as you bend and straighten it ⁶. Expect to be asked how the finger behaves first thing in the morning, too. Stiffness and locking tend to be worse after the hand has been still for a while ⁶.

We start by working out how established it is: does the finger free itself, need your other hand, or stay stuck? That changes what makes sense.

Manual therapy. We may use gentle hands-on work for stiffness around the hand. To be straight with you, none of the research behind this page tested manual therapy for trigger finger itself. We treat it as a supporting tool, not the main treatment.

Anti-inflammatory medication. Medicines such as ibuprofen are a non-surgical option ^1,2. That's a conversation for your GP or pharmacist. We don't prescribe them.

Steroid injection. It treats the problem in up to 6 in 10 people, though more than one may be needed ¹. Injections are outside a physiotherapist's scope of practice, so we don't give them. Splinting's short-term results have been described as comparable, without risks such as skin thinning or infection ³.

Surgery. Usually considered only when other treatments haven't worked, often after one or two injections ^1,2. Risks include numbness, a tender scar, bowstringing (the tendon lifting away from the bone) and ongoing stiffness ¹.

An honest note: most splinting studies are small and short term, success rates range from 27% to 97% ^3,5, and long-term results still need research ³. Good evidence, not settled evidence.

Trigger finger care follows The Well Motion Recovery Path™. You move up a phase when the finger glides more freely, not because a set number of weeks has passed.

• Reset: the splint weeks. A blocking splint, worn day and night if you can manage it ³, while you cut back the gripping that sets the finger off ². Expect the catching to ease before it stops. We move you on when the finger catches less often and hurts less when it does.
• Rebuild: tendon gliding exercises added to the splint, never swapped for it ^4,5, then hand rehabilitation for stiffness and grip weakness. We move you on when the hand does what your daily tasks ask of it. If the catching hasn't changed, we send you back to your GP to discuss an injection or surgery ^1,2.
• Return: back to the tools, the kitchen or the racquet. We check the grips that used to set it off. You leave with a plan for flare-ups: ease the load early ² and keep the finger straight overnight ⁶.

How long it usually takes. Splints in the research were worn for 6 to 12 weeks ³. In one group of 452 people followed for three weeks after a steroid injection, with no comparison group, 65.9% said the triggering had gone completely ⁹. After surgery, swelling and stiffness can take 4 to 6 months to settle ⁶. Nothing we found says how long an untreated finger takes.

Nobody has trialled a way to prevent trigger finger, and most cases have no clear cause ⁶. What has been measured is who gets it:

• Watch how hard and how often you grip. A study followed 516 factory workers for six years. The more strain a job put on the hands, the more likely a worker was to develop a trigger finger or thumb ⁷. Repetitive gripping and pinching, at work or for fun, is a named risk ⁶. When the catching comes back, cut down whatever sets it off until it eases ².
• If you have diabetes, your blood sugar counts. Among nearly 260,000 people with diabetes, those with an HbA1c above 7% had 23 to 35% higher odds of trigger finger than those below it ⁸. That's one to raise with your GP or diabetes team.
• Keep the finger straight overnight. A splint worn at night holds the finger or thumb straight while you sleep ⁶, so it can't bend ¹.