No, surgery is definitely not the only option, and we almost always try conservative treatments first. For trigger thumb, non-surgical treatments are highly effective. These include resting your hand, wearing a splint at night, and doing gentle stretching exercises. To help with inflammation and pain, over-the-counter medications like ibuprofen can be very useful. If these steps don't resolve the issue, a localised corticosteroid injection into the tendon sheath is a very common and highly successful non-surgical treatment. Surgery is typically considered a last resort only if these other treatments fail to provide relief. You have several excellent, non-invasive options to try first.