What exercises can help alleviate symptoms of trigger finger?

Trigger Finger Exercise Recommendations

For trigger finger, therapeutic exercises including stretching, active range-of-motion exercises, and manual techniques should be implemented, though they are less effective than corticosteroid injection for initial symptom relief but may help prevent recurrence.

Evidence-Based Exercise Protocol

Specific exercises to implement include:

• Stretching exercises for wrist flexors and extensors should be performed regularly, as these improve functionality and reduce pain in hands and wrists 1
• Active range-of-motion exercises focusing on gentle finger flexion and extension movements help restore normal tendon gliding 1
• Manual lymph drainage techniques can reduce swelling around the affected flexor tendon sheath 1
• Strengthening exercises should be gradually introduced once acute symptoms improve to restore grip strength 2

Implementation Strategy

The exercise program should follow this approach:

• Begin with gentle stretching and range-of-motion exercises, avoiding forceful movements that trigger locking 1
• Progress to strengthening exercises only after triggering symptoms have substantially improved 3
• Exercises should be supervised initially by a physical or occupational therapist to ensure proper technique 1
• Continue exercises regularly and long-term, as benefits diminish during follow-up periods (up to 12 months) without ongoing therapy 1

Comparative Effectiveness

Important caveats about exercise efficacy:

• Physiotherapy alone has a 68.6% success rate at 3 months for mild trigger fingers, compared to 97.4% for corticosteroid injection 4
• Patients treated with physiotherapy have lower pain scores, slower recovery, and weaker grip strength initially compared to injection 4
• However, physiotherapy may have a role in preventing recurrence, as patients who successfully respond to exercises show no recurrence of pain or triggering at 6 months, possibly due to awareness and ability to self-treat early symptoms 4

Adjunctive Physical Therapy Modalities

Beyond exercises, consider:

• Extracorporeal shock wave therapy (ESWT) is effective and safe for conservative management, reducing pain and trigger severity while improving functional level and quality of life 5
• Ultrasound therapy has proven useful to prevent recurrence of trigger finger symptoms 5
• Biofeedback techniques can be incorporated to improve exercise performance 1

Splinting Combined with Exercise

Splinting should be considered alongside exercises:

• Splint the metacarpophalangeal joint at 10-15 degrees of flexion for 3-9 weeks (average 6 weeks) 6
• Splinting alone has a 66% success rate, with 50% success for thumbs and 70% for fingers 6
• The combination of splinting plus steroid injection offers no additional benefit over either treatment alone 7
• Patients with marked triggering, symptoms exceeding 6 months, or multiple involved digits have higher failure rates with conservative treatment 6

Clinical Algorithm

Recommended treatment sequence:

1. For mild trigger fingers (mild crepitus, uneven movements, actively correctable triggering): Start with splinting plus exercises for 6 weeks 6, 4
2. If unsuccessful after 6 weeks: Proceed to corticosteroid injection, which cures 88% of splinting failures 6
3. For moderate-to-severe triggering: Consider corticosteroid injection as first-line treatment given superior initial outcomes 4
4. After successful treatment: Continue maintenance exercises to prevent recurrence 4
5. If injection fails: Surgical release is indicated 6

Key Pitfalls to Avoid

• Do not rely solely on exercises for moderate-to-severe triggering, as success rates are significantly lower than injection 4
• Avoid discontinuing exercises after symptom resolution, as benefits are not sustained without ongoing practice 1
• Do not use forceful stretching or strengthening during acute triggering episodes, as this may worsen symptoms 1
• Recognize that patients with symptoms exceeding 6 months have poorer outcomes with conservative treatment and may require earlier surgical intervention 6