What is the treatment for a finger sprain?

Treatment of Finger Sprains

The recommended treatment for finger sprains consists of the RICE protocol (Rest, Ice, Compression, and Elevation) for 3-5 days, followed by early active exercise and appropriate support with a splint or tape. 1, 2

Initial Management (First 3-5 Days)

1. Rest and Activity Limitation

   • Immediately remove from activity that causes pain 1
   • Avoid activities that cause pain to prevent worsening the injury 1
   • Limit use of the injured finger to promote healing 2

2. Ice Application (Cryotherapy)

   • Apply cold (ice wrapped in a damp cloth) to the injured area as soon as possible 1, 3
   • Limit cold application to 20-30 minutes per session 1
   • Repeat 3-4 times daily for several days 1, 3
   • Never place ice directly on skin to avoid cold injury 1

3. Compression

   • Apply a compression wrap to promote comfort 1
   • Ensure compression does not compromise circulation 1
   • For PIP joint sprains specifically, compression helps reduce periarticular swelling 4

4. Elevation

   • Keep the injured finger elevated to reduce swelling 2, 3

Support Options

1. Splinting

   • Splints can be used for protection and immobilization 5
   • Options include:
     • Buddy splinting (taping injured finger to adjacent finger) for lateral stability 5
     • Dorsal finger block splint for PIP joint protection 5

2. Kinesio Taping

   • May be superior to splinting for PIP joint sprains in terms of:
     • Better edema reduction 4
     • Improved joint range of motion 4
     • Less nighttime pain 4
     • Higher patient compliance 4

Pain Management

• Acetaminophen is preferred over aspirin for mild pain due to aspirin's effect on blood coagulation 3
• NSAIDs can be used for short-term pain relief 2

Rehabilitation (After Initial 3-5 Days)

1. Early Active Exercise

   • Begin gentle range of motion exercises within 48-72 hours 2
   • Progress to strengthening exercises for the finger 2

2. Return to Activity Criteria

   • Pain-free movement
   • Restored range of motion
   • Restored strength
   • Ability to perform specific movements required for daily activities or sports 2

Important Considerations and Pitfalls

1. Misdiagnosis Risk

   • Finger sprains are commonly misdiagnosed; what appears to be a sprain may actually be:
     • Closed tendon injuries
     • Intra-articular fractures
     • Volar plate avulsions 6
   • Proper diagnosis requires thorough examination and appropriate imaging 6

2. Long-Term Sequelae

   • Be aware that PIP joint sprains often result in prolonged symptoms:
     • 37% of patients continue to experience swelling beyond one year 7
     • Many patients experience ongoing stiffness and functional limitations 7
     • Patients should be counseled about potential prolonged recovery 7

3. Medical Attention

   • Seek medical attention for:
     • Severe pain
     • Significant swelling
     • Deformity
     • Inability to move the finger
     • Suspected fracture 1

By following this structured approach to finger sprain management, patients can expect optimal healing and return to function while minimizing complications and long-term sequelae.