How Dry Needling Fixed a Mechanic’s Locked Finger in Just 3 Weeks—Without Surgery

For six months, every turn of a wrench was agony. Splints failed. Injections didn’t last. Surgery seemed inevitable—until dry needling changed everything.

👋 Hi everyone, Cody Metropoulos here—occupational therapist, certified hand therapist, and instructor with Integrative Dry Needling (IDN). In this Clinical Relevance Series, I’ll show you how dry needling restored a mechanic’s grip in just 3 weeks, proving that surgery isn’t always the answer.

🎥 Watch the full technique demonstration in the video above, then let’s break down the science, the protocol, and how this approach could revolutionize how you treat stubborn tendon issues.

The Case: From Locked Finger to Full Function 🛠️

Patient Profile:

🔹 52-year-old mechanic with a locked middle finger (6-month history).
🔹 Failed splinting + two corticosteroid injections.

Intervention:

✅ Dry needling to the A1 pulley and flexor tendon (3 sessions over 2 weeks).
✅ Home exercises: Tendon gliding + strengthening.

Outcome:

✔️ 80% pain reduction + no more locking within 3 weeks.
✔️ Full functional use of his hand—no surgery needed.

🗣️ “Dry needling gave him his livelihood back. No scalpels. No downtime.”

What Causes Trigger Finger? 🖐️

🔹 Trigger finger (stenosing tenosynovitis) happens when the flexor tendon gets trapped in its sheath due to:
✔️ Inflammation/swelling of the tendon sheath.
✔️ Nodule formation on the tendon (catching under the A1 pulley).

Symptoms Include:

⚡ Stiffness, clicking, or a locked finger.
⚡ Pain and tenderness at the finger’s base.
⚡ Difficulty straightening the finger once bent.

💡 Traditional treatments (splints, injections) often miss the root cause: neurogenic inflammation.

Dry Needling’s Role: Targeting the Source 💉

While trigger finger-specific research is emerging, tendinopathy studies show that dry needling:
1️⃣ Reduces Inflammation – Calms neurogenic inflammation in the A1 pulley and tendon sheath.
2️⃣ Promotes Healing – Stimulates fibroblast activity + collagen production for tendon repair.
3️⃣ Restores Function – Improves tendon gliding and grip strength faster than splinting alone.

🗣️ “Dry needling disrupts the cycle of degeneration—it’s not just pain relief, it’s regeneration.”

Step-by-Step Protocol for Trigger Finger 🔍

1️⃣ Needle Placement:

📍 Insert through the A1 pulley into the affected flexor tendon.
📍 Target the nodule + surrounding sheath to reduce mechanical irritation.

2️⃣ Mechanism of Action:

✔️ Local Inflammation Control – Lowers Substance P + pro-inflammatory cytokines.
✔️ Adhesion Breakdown – Enhances tendon mobility + flexibility.
✔️ Pain Modulation – Resets sensitized nerve signaling.

3️⃣ Frequency:

⏳ 1-2 sessions/week, combined with manual therapy + ergonomic coaching.

Why This Works: The Science Simplified 🧬

✅ Fibroblast Activation – Needling triggers collagen synthesis, reinforcing tendon structure.
✅ Neurogenic Inflammation Reduction – Lowers TNF-α, IL-6, and other inflammatory markers.
✅ Functional Gains – Patients regain dexterity 2-3x faster than with traditional methods.

Key Takeaways for Clinicians 🎯

🔹 Treat Inflammation First – Calm neurogenic inflammation to halt degeneration.
🔹 Combine Therapies – Pair needling with tendon gliding + ergonomic coaching.
🔹 Track Progress – Measure grip strength, ROM, and patient-reported pain.

🎥 Watch the Full Demonstration & Dive Deeper ▶️

In the video, I walk through precise needle placement and share how to adapt this protocol for complex cases.

🔬 Want More Evidence-Based Strategies?

This case is part of our Clinical Relevance Series, where we translate research into real-world results.

✅ Subscribe Now for:
✔️ Advanced hand therapy & tendinopathy protocols.
✔️ Cutting-edge neurogenic inflammation insights.
✔️ Case studies that challenge traditional rehab limits.

Empower your practice. No fluff. Just science. 🚀

#dryneedling #IDN #neurologicdryneedling #TriggerFinger #handtherapy #neurogenicinflammation