From the Research
Trigger finger treatment should start with conservative measures, including rest, avoiding activities that cause pain, and using over-the-counter pain relievers like ibuprofen or naproxen to reduce inflammation, followed by a corticosteroid injection into the tendon sheath, typically with 20mg of triamcinolone acetonide, as this dosage has been shown to have a significantly higher rate of clinical effectiveness at 6-month follow-up 1.
Treatment Options
- Rest and avoiding activities that cause pain
- Over-the-counter pain relievers like ibuprofen (400-800mg three times daily) or naproxen (220-500mg twice daily) to reduce inflammation
- Splinting the affected finger in a straight position, especially at night for 6-8 weeks, to help prevent triggering
- Corticosteroid injection into the tendon sheath, typically with 20mg of triamcinolone acetonide, as this has been shown to be the most effective dosage 1
- Surgical release of the A1 pulley (trigger finger release) for persistent cases, which can be performed as an outpatient procedure under local anesthesia 2
Important Considerations
- The use of lidocaine with epinephrine in corticosteroid injections may increase injection-associated pain, and its exclusion may be preferred to decrease pain 3
- The effectiveness of corticosteroid injections can be graded as silver level evidence for superiority over injections with lidocaine alone 4
- Trigger finger occurs when inflammation narrows the space within the tendon sheath, causing the tendon to catch or lock when the finger bends and straightens, and treatment aims to reduce this inflammation and restore smooth tendon movement through the sheath
Additional Therapies
- Physical therapies, such as external shock wave therapy (ESWT) and ultrasound therapy (UST), may be effective in reducing pain and trigger severity, and improving functional level and quality of life, although more research is needed to understand the optimal treatment protocol 5