Trigger finger and trigger thumb are common conditions resulting from stenosing tenosynovitis of the flexor tendons at the level of the metacarpals. The condition develops when the tendon sheath at the base of the affected finger becomes inflamed and thickened — narrowing the canal through which the flexor tendon must glide. The result is mechanical: the tendon catches at the constriction during finger extension, sometimes producing an audible pop as it forces past the narrowed segment. For affected patients, this catching is more than annoying — trigger finger is one of the most common causes of pain, discomfort, and disability of the hand. Routine activities like making a fist, gripping a steering wheel, or simply opening a clenched hand become uncomfortable or painful. The good news is that trigger finger responds excellently to treatment — typically beginning with cortisone injection and, when conservative measures fail, addressed definitively with a brief outpatient surgical procedure. At Los Angeles Plastic Surgery, Dr. John Anastasatos provides relief for trigger finger and trigger thumb with the depth of training this anatomically precise treatment specifically rewards.

Dr. Anastasatos performs trigger finger treatment with the most directly relevant academic credential possible: he completed a fellowship in Hand and Upper Extremity Surgery and Microsurgery at the University of Alabama at Birmingham — formal subspecialty training in the precise anatomy of the flexor tendon system that few cosmetic plastic surgeons possess. He has presented at Cedars-Sinai Medical Center Grand Rounds on advanced surgical techniques — teaching credentials at one of the leading medical institutions in Southern California. With over two decades of facial and hand surgical expertise in Beverly Hills since 2007, he is board certified by the American Board of Plastic Surgery, a Fellow of the American College of Surgeons (FACS), a member of the American Society of Plastic Surgeons (ASPS) and American Society for Aesthetic Plastic Surgery (ASAPS), and named by The Luxe Insider as one of the Top 10 Plastic Surgeons in the World.

Symptoms of Trigger Finger

The hallmarks of trigger finger include:

• Catching of the flexor tendon at the metacarpal level during finger extension
• Popping that may be audible as the tendon forces past the constriction
• Pain at the base of the affected finger — often the most prominent complaint
• Stiffness in the affected finger — particularly first thing in the morning
• In severe cases, locking — the finger becomes fixed in flexion until the patient manually extends it

Cortisone Injection — First-Line Therapy

The first-line treatment for trigger finger is cortisone injection — and the technique matters meaningfully for the result. Dr. Anastasatos typically uses Kenalog 10 or Kenalog 40, diluted with 1% lidocaine for patient comfort. The critical technical point is precision: the injection must target the stenosing pulley space or sub-space itself, not the surrounding tissues. Injection technique that allows the cortisone to seep into surrounding tissues produces poor results and risks complications. Accurate targeting requires expertise.

The treatment progression typically follows this pattern:

• Initial cortisone injection — effective in the majority of patients, with relief lasting from a few months to many years
• Second injection if symptoms recur — used when initial relief is followed by recurrence
• Third injection in some patients — for those whose symptoms partially respond

If symptoms of catching and popping persist or never completely resolve despite appropriate injection therapy, surgery becomes the definitive treatment.

Trigger Finger Release Surgery

Trigger fingers and trigger thumbs respond excellently to surgical therapy. Surgery is the definitive treatment for refractory trigger digits and offers reliable, lasting relief.

The procedure involves:

• Small 2 cm incision over the metacarpal at the level of the affected pulley
• Release or division of the constricting band or pulley — opening the narrowed canal so the tendon can glide freely
• Direct visualization — ensures complete release without damage to adjacent structures

Recovery After Trigger Finger Surgery

Recovery from trigger finger release surgery is straightforward:

• Immediate relief of the catching and popping
• Soft splint dressing post-procedure
• Sutures removed at approximately 10-14 days post-procedure
• Quick return to normal activities with minimal restriction

Schedule a Trigger Finger Consultation in Beverly Hills

If you have a finger that catches, pops, or locks during normal motion — or pain at the base of a finger affecting your daily activities — Dr. Anastasatos welcomes patients to the Beverly Hills office at 436 North Bedford Drive, Suite 202, Beverly Hills, CA 90210, for a private consultation. Contact Los Angeles Plastic Surgery to schedule your appointment.