From the Guidelines
Trigger finger treatment typically begins with rest, avoiding activities that cause pain, and using over-the-counter pain medications like ibuprofen (400-800mg three times daily) or naproxen (220-500mg twice daily) to reduce inflammation, as recommended by the American Family Physician in 2005 1. The goal of treatment is to reduce inflammation, restore smooth tendon movement, and prevent further injury.
- Rest and avoiding activities that cause pain are essential to prevent further injury and promote healing.
- Over-the-counter pain medications like ibuprofen or naproxen can help reduce inflammation and relieve pain.
- Splinting the affected finger in a straight position, especially at night for 6-8 weeks, can help prevent the finger from locking. For more persistent cases,
- a corticosteroid injection into the tendon sheath (typically methylprednisolone or triamcinolone) is often effective, with about 70% of patients experiencing relief after one or two injections, as supported by the American Family Physician in 2005 1.
- Physical therapy exercises that gently stretch and strengthen the hand can also be beneficial. If conservative treatments fail after 3-6 months,
- surgical release of the A1 pulley (either open or percutaneous) may be necessary, which has a success rate over 90%, as noted in the American Family Physician in 2005 1. Surgery is typically an outpatient procedure with a recovery period of 2-4 weeks. Trigger finger occurs when inflammation narrows the space within the tendon sheath, causing the tendon to catch or lock when moving the finger, so treatments aim to reduce this inflammation and restore smooth tendon movement, as explained in the American Family Physician in 2005 1.
From the Research
Trigger Finger Treatment Options
- Conservative management: includes NSAIDs, hand splints, corticosteroid injections, physical therapies, and percutaneous or open surgery 2
- Physical therapies: external shock wave therapy (ESWT) and ultrasound therapy (UST) have been shown to be effective in reducing pain and trigger severity, and improving functional level and quality of life 2
- Interdisciplinary care protocol: redirects referrals for surgical consultations to conservative management first, with physical therapy as the initial treatment, followed by corticosteroid injections or surgical management if necessary 3
Effectiveness of Different Treatments
- ESWT: effective and safe therapy for the conservative management of trigger finger, reducing pain and trigger severity, and improving functional level and quality of life 2
- UST: useful in preventing the recurrence of trigger finger symptoms 2
- Corticosteroid injections: effective in treating trigger finger, with a 20-mg dose showing a significantly higher rate of clinical effectiveness at 6-month follow-up compared to 5-mg and 10-mg doses 4
- Orthotic management: immobilizing a single joint of the affected digit for 6-10 weeks can be effective in reducing pain and triggering symptoms 5
Rehabilitation and Management
- Comprehensive assessment: includes medical history, physical examination, functional scales, and ultrasound examination of the affected finger 6
- Rehabilitation panel: combines traditional and novel techniques, including physical therapy, orthosis, and patient education, to provide tailored management for trigger finger patients 6
- Patient-reported outcomes: important for assessing patient function and sensitivity to change in patients with trigger finger, and should be used in future studies 5