From the Guidelines
Trigger finger can be effectively treated with a combination of rest, anti-inflammatory medications, and corticosteroid injections, with surgery being a viable option for severe cases that do not respond to conservative therapy. When managing trigger finger, it is essential to prioritize treatments that reduce inflammation and promote tendon healing.
- Resting the affected finger and avoiding activities that exacerbate the condition is crucial, as it prevents further damage and promotes healing 1.
- Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can be used to reduce inflammation and pain, although they have no effect on long-term outcomes 1.
- Corticosteroid injections into the tendon sheath may be more effective than oral NSAIDs in acute-phase pain relief, providing relief in a significant percentage of patients 1. Some treatments, such as therapeutic ultrasonography, corticosteroid iontophoresis, and phonophoresis, are of uncertain benefit for tendinopathy and should not be considered as first-line treatments 1. In cases where conservative treatments fail after 3-6 months, surgery is an effective option for carefully selected patients 1. It is also important to note that while extracorporeal shock wave therapy appears to be a safe and effective means of pain relief, it is expensive and may not be a viable option for all patients 1. Overall, a step-wise approach to treatment, starting with conservative measures and progressing to more invasive options as needed, is the most effective way to manage trigger finger and improve patient outcomes.
From the Research
Treatment Options for Stenosing Tenosynovitis (Trigger Finger)
- Non-surgical treatment options include:
- Activity modification
- Oral and topical non-steroidal anti-inflammatory drugs (NSAIDs) 2
- Splinting
- Local injections with anti-inflammatory drugs
- Physical therapies, such as 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 3
- Surgical treatment options include:
- Percutaneous A1 pulley release
- Open A1 pulley release
- Excision of a slip of the flexor digitorum superficialis 4
Patient Preference for Treatment
- A survey of 316 participants found that the most preferred treatment options were:
- Observation (37%)
- Splinting (27%)
- Corticosteroid injection (19%)
- Surgery (16%) 5
Multidisciplinary Consensus Guideline
- A European Delphi consensus strategy achieved consensus on a multidisciplinary treatment guideline for trigger finger, which includes:
- Use of orthoses (splinting)
- Corticosteroid injections
- Corticosteroid injections plus use of orthoses
- Surgery
- The guideline identifies the severity and duration of the disease and previous treatments received as main factors for selecting a treatment option 6