Trigger finger, also known as stenosing tenosynovitis, is a common hand condition that affects the tendons in your fingers or thumb. If you're dealing with pain, stiffness, or a locking sensation in your fingers, you may be exploring solutions—and surgery might have come up in your research.

While surgery is often presented as a definitive fix for trigger finger, it’s important to approach it as one of many options. In this post, we’ll explore what trigger finger surgery involves, the recovery process, and why it may be worth considering less invasive treatments first.

What Is Trigger Finger?

Trigger finger, also known as stenosing flexor tenosynovitis, is a condition where the movement of a finger flexor tendon through the first annular (A1) pulley is impaired due to degeneration, inflammation, and swelling. This results in pain and restricted movement of the affected finger, often characterized by a clicking or popping sound when moving the finger, pain or tenderness at the base of the affected finger or thumb, finger stiffness, especially in the morning, and in severe cases, the finger may become locked in a bent position [Leow et al, 2021; Currie et al, 2022].

Symptoms of trigger finger include:

• A clicking or popping sound when you move your finger

• Pain or tenderness at the base of the affected finger or thumb

• Finger stiffness, especially in the morning

• In more severe cases, your finger may become locked in a bent position

Trigger finger is more common in individuals who perform repetitive gripping actions, have diabetes, or suffer from rheumatoid arthritis. Studies have shown that up to 20% of adults with diabetes and approximately 2% of the general population are affected by trigger finger [Currie et al, 2022].

Additionally, high HbA1c levels are associated with an increased risk of developing trigger finger in individuals with both type 1 and type 2 diabetes [Rydberg et al, 2022].

When Is Trigger Finger Surgery Recommended?

Trigger finger surgery is recommended when conservative treatments fail to provide relief after several months, or if the finger is completely locked. Conservative treatments include:

• Rest and activity modification

• Splinting the affected finger to reduce strain

• Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and swelling

• Corticosteroid injections to relieve inflammation

If you've tried these approaches for several months without relief—or if the finger is completely locked—your provider might recommend a surgical release. But before you move forward, it's worth understanding exactly what the procedure involves and what the road to recovery looks like.

What Happens During Trigger Finger Surgery?

The procedure involves making a small incision in the palm to release the A1 pulley, which allows the tendon to move freely. This can be done through open surgery or percutaneous techniques. Open surgery is the traditional method and is widely used due to its effectiveness in resolving symptoms [Gil et al, 2020; Fiorini et al, 2018].

There are two main types:

1. Open surgery – An incision is made in the palm to access and release the sheath.

2. Minimally Invasive Ultrasound Guided release – Real-time ultrasound imaging is used to clearly visualize the tendon and nearby structures throughout the procedure. Under live imaging, a small instrument or micro-blade is inserted through a tiny skin puncture—usually just 2 to 3 millimeters wide—to carefully release the tight pulley that's restricting the tendon’s movement.

3. Percutaneous release – A needle is inserted into the skin to release the tendon sheath without a formal incision and often without imaing

Both methods are generally quick—often under 30 minutes—and performed with local anesthesia.

What to Expect After Open Surgery

While open surgery can offer long-term relief for many people, recovery is not always instant. Here’s what to expect in the days and weeks following the procedure:

Recovery from trigger finger surgery typically involves

• Immediate post-operative care: Patients may experience some pain and swelling, which can be managed with NSAIDs and ice.
• Wound care: Keeping the incision clean and dry to prevent infection.
• Physical therapy: Gentle finger exercises to restore range of motion and prevent stiffness.
• Return to activities: Most patients can resume normal activities within a few weeks, although full recovery may take several months [Gil et al, 2020; Fiorini et al, 2018; Currie et al, 2022].

What are the Risks of Open Trigger Finger Surgery:

Surgery for trigger finger is generally safe, but as with any procedure, there are risks:

• Infection: Although rare, infections can occur postoperatively and may require antibiotic treatment or further surgical intervention [Koopman et al, 2022; Fiorini et al, 2018].
  
• Stiffness or pain that persists post-surgery: Some patients may experience ongoing pain or stiffness, which can affect hand function and may require additional therapy [Gil et al, 2020; Fiorini et al, 2018].
• Nerve injury: While uncommon, there is a risk of injury to the digital nerves during the procedure, which can lead to numbness or tingling in the affected finger [Fiorini et al, 2018; Will & Lubahn, 2010].
• Scarring or sensitive scar tissue: Postoperative scarring can lead to tenderness or sensitivity at the incision site, which may persist for some time [Fiorini et al, 2018; Will & Lubahn, 2010].
• Recurrence of trigger finger: In some cases, the condition may recur, necessitating further treatment. Factors such as multiple preoperative steroid injections and manual labor increase the risk of recurrence [Fiorini et al, 2018; Atthakomol et al, 2023].

It is worth noting that while many patients find relief from surgery, others report new issues such as palm sensitivity or reduced grip strength. This is why for some individuals, especially those with milder symptoms, open surgery may not be the best first step [Fiorini et al, 2018; Abdul et al, 2023; Gil et al, 2020].

Why Consider Non-Surgical Alternatives First?

Surgery may seem like a quick fix, but many people see significant improvements through non-invasive means. In fact, studies have shown that up to 70% of people respond well to corticosteroid injections, especially when trigger finger is caught early [Peters-Veluthamaningal et al, 2009].

Other conservative treatments include:

• Stretching exercises: Gentle daily stretches can help loosen the tendon and reduce stiffness [Donati et al, 2025].

• Splinting at night: Keeps the finger in an extended position and allows the tendon to rest. Splinting alone has been shown to be effective in reducing pain and improving function [Atthakomol et al, 2023].

• Ergonomic adjustments: If your trigger finger is linked to repetitive work, modifying tools or techniques can help reduce strain [Currie et al, 2022].

• Physical therapy: Targeted exercises and soft tissue mobilization can reduce inflammation and improve function. An interdisciplinary approach involving physical therapy has been successful in managing trigger finger symptoms [Yanko et al, 2025].

These options are typically less expensive, lower risk, and come with minimal downtime—making them attractive choices to explore before jumping into surgery.

A Minimally Invasive Option: Ultrasound-Guided Trigger Finger Release

If you’re considering surgery but are hesitant about the invasiveness of traditional open or percutaneous procedures, ultrasound-guided trigger finger release might offer a compelling middle ground.

This relatively new technique combines real-time imaging with minimally invasive tools to release the tendon sheath—without the need for a large incision or blind needle passes.

How It Works

In this procedure, a high-frequency ultrasound probe is used to visualize the tendon and surrounding structures in real time. Under this guidance, a tiny blade or specialized instrument is inserted through a small puncture in the skin—typically just 1-2 mm wide—to precisely cut the pulley causing the restriction.

Because the imaging allows for direct visualization of the tendon, blood vessels, and nerves, the release can be done with greater accuracy and minimal risk.

Benefits of Ultrasound-Guided Release

Many patients are drawn to this technique because it offers the potential for:

• Minimally invasive approach: The procedure involves a small puncture rather than a large incision, reducing the risk of infection and scarring [Amro et al, 2024; Garcia et al, 2024].
• Quicker recovery: Studies have shown that patients undergoing ultrasound-guided release experience faster return to normal activities compared to traditional open surgery [Amro et al, 2024; Garcia et al, 2024]..[1-3]
• Reduced postoperative pain: The precision of ultrasound guidance minimizes tissue damage, leading to less postoperative pain and quicker cessation of analgesics [Garcia et al, 2024; Rodríguez-Maruri et al, 2023].
• High success rates: Clinical trials and systematic reviews have demonstrated high success rates and patient satisfaction with ultrasound-guided release, with significant improvements in functional outcomes [Amro et al, 2024; Garcia et al, 2024; Chopin et al, 2022].

What to Consider

While the ultrasound-guided method has shown promising outcomes, it’s not yet available everywhere, and not all hand surgeons are trained in the technique.

If you’re seeking an option that’s more precise than percutaneous release but less invasive than open surgery, it’s worth asking your provider if this method is available in your area.

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References:

1. Abdul Nasir M, Ahmad TS, Low TH, Devarajooh C, Gunasagaran J. Flexor tendon degeneration affects short-term outcomesof open trigger digit release. PLoS One. 2023 May 30;18(5):e0286301.
   
2. Amro S, Kashbour M, Shaaban Abdelgalil M, Qafesha RM, Eldeeb H. Efficacy of Ultrasound-Guided Tendon Release for Trigger Finger Compared With Open Surgery: A Systematic Review and Meta-Analysis. J Ultrasound Med. 2024 Apr;43(4):657-669.
   
3. Atthakomol P, Manosroi W, Sathiraleela K, Thaiprasit N, Duangsan T, Tapaman A, Sripheng J. Prognostic factors related to recurrence of trigger finger after open surgical release in adults. J Plast Reconstr Aesthet Surg. 2023 Aug;83:352-357.
   
4. Chopin C, Le Guillou A, Salmon JH, Lellouche H, Richette P, Maillet J. Treatment of Trigger finger by ultrasound-guided needle release of a1 pulley: A series of 105 cases. Joint Bone Spine. 2022 Nov;89(6):105433.
   
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7. Fiorini HJ, Tamaoki MJ, Lenza M, Gomes Dos Santos JB, Faloppa F, Belloti JC. Surgery for trigger finger. Cochrane Database Syst Rev. 2018 Feb 20;2(2):CD009860.
   
8. Garcia HRP, Mund E, Romeiro P. Ultrasound-guided vs. non-guided trigger finger release: a systematic review and meta-analysis. Int Orthop. 2024 Sep;48(9):2429-2437.
   
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10. Koopman JE, Hundepool CA, Duraku LS, Smit JM, Zuidam JM, Selles RW, Wouters RM; Hand-Wrist Study Group. Complications and Functional Outcomes following Trigger Finger Release: A Cohort Study of 1879 Patients. Plast Reconstr Surg. 2022 Nov 1;150(5):1015-1024.
    
11. Leow MQH, Zheng Q, Shi L, Tay SC, Chan ES. Non-steroidal anti-inflammatory drugs (NSAIDs) for trigger finger. Cochrane Database Syst Rev. 2021 Apr 14;4(4):CD012789.
    
12. Peters-Veluthamaningal C, van der Windt DA, Winters JC, Meyboom-de Jong B. Corticosteroid injection for trigger finger in adults. Cochrane Database Syst Rev. 2009 Jan 21;(1):CD005617.
    
13. Rodríguez-Maruri G, Rojo-Manaute JM, Capa-Grasa A, Chana Rodríguez F, Cerezo López E, Vaquero Martín J. Ultrasound-Guided A1 Pulley Release Versus Classic Open Surgery for Trigger Digit: A Randomized Clinical Trial. J Ultrasound Med. 2023 Jun;42(6):1267-1275.
    
14. Rydberg M, Zimmerman M, Gottsäter A, Eeg-Olofsson K, Dahlin LB. High HbA1c Levels Are Associated With Development of Trigger Finger in Type 1 and Type 2 Diabetes: An Observational Register-Based Study From Sweden. Diabetes Care. 2022 Nov 1;45(11):2669-2674.
    
15. Will R, Lubahn J. Complications of open trigger finger release. J Hand Surg Am. 2010 Apr;35(4):594-6.
16. Yanko E, Thomson C, Bourassa R, Gasmo C, Le T, Crockett K. A collaborative interdisciplinary approach for trigger finger management. J Hand Ther. 2025 Jan 15:S0894-1130(24)00169-8.