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Finger Locking: Causes, Symptoms & Treatment Options

Trigger finger (stenosing tenosynovitis) causes catching, locking, or popping of a finger during flexion/extension.

Causes

  • Repetitive gripping, forceful hand use
  • Diabetes, rheumatoid arthritis, gout, amyloidosis
  • Post-traumatic (rare)
  • Idiopathic

Pathophysiology

Thickening of A1 pulley and/or flexor tendon nodule → mechanical impingement at metacarpal head.

Symptoms

  • Stiffness, clicking, catching
  • Locked in flexion (may need passive extension)
  • Palmar tenderness at A1 pulley
  • Worse in morning

Treatment

  1. Rest, activity modification, splinting (extension night splint 6–8 weeks).
  2. NSAIDs.
  3. Corticosteroid injection into tendon sheath – curative in ~60–70% (lower in diabetes).
  4. Percutaneous or open A1 pulley release – definitive for refractory cases.

    5. Early intervention improves non-surgical success.

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