A common complaint from patients in the hand therapy clinic is that their fingers are “locking.” Locking in the fingers is most commonly associated with a condition called trigger finger, which occurs when there is inflammation around the tendons that bend the fingers.

To bend our fingers or thumbs, we use tendons connected to muscles located in the forearm. These tendons must travel through a series of pulleys, or tunnels, that hold the tendons close to the bone. The entrance to the first pulley is often a site of inflammation. If there is inflammation in the area, the tendon does not glide easily and can get stuck, causing the finger to lock in a bent position.

Patients often report pain, clicking, and popping in the affected finger. As people continue to bend their fingers, the inflammation and triggering increases. Over time, the finger becomes stiff or more difficult to move, and pain may continue to increase.

Amanda Walsh, MD

In this Q&A, Amanda Walsh, MD a fellowship trained hand and upper extremity surgeon and Assistant Professor of Orthopedic Surgery at the Icahn School of Medicine at Mount Sinai, explains what you can do about this condition.

How can I treat finger locking?

The best way to prevent worsening of the symptoms of trigger finger is to stop the cycle of inflammation. Try the following to decrease triggering:

• Avoid repetitive and sustained gripping tasks, such as playing golf, hitting balls in the batting cages or gardening with tools.
• Maintain motion of the fingers by gentle flexion and extension, which can help prevent stiffness.

What if my symptoms persist?

If symptoms persist for more than one month, seek medical attention. A hand surgeon can help diagnose a trigger finger and provide treatment, which may include corticosteroid injection and/or an occupational therapy referral. If these treatments do not work, some people need to undergo surgery for this problem.

How do corticosteroid injections help?

A corticosteroid injection delivers a strong anti-inflammatory to the area of inflammation in the hand. In the majority of patients, corticosteroid injection can provide permanent relief of symptoms after just one injection.

How does occupational therapy help?

Occupational therapy can be very beneficial for decreasing the pain and stiffness associated with trigger fingers. Patients are often taught about modifying daily tasks to decrease triggering, such as avoiding gripping tasks and performing gripping tasks in a manner that avoids using the inflamed tendons. Therapists also may teach patients range-of-motion exercises to decrease the stiffness and enable the patient to bend and straighten the finger fully.

To make an appointment to see one of our hand specialists, call 877-636-7846 or email orthopedics@mountsinai.org.