From the Guidelines
Trigger finger treatment options are primarily non-surgical, with a focus on reducing inflammation and relieving pressure on the affected tendon.
Treatment Options
- Non-steroidal anti-inflammatory drugs (NSAIDs): to reduce pain and inflammation, although the evidence provided does not specify the use of NSAIDs for trigger finger, it is a common practice in clinical medicine.
- Corticosteroid injections: into the tendon sheath to reduce inflammation, which is a common treatment for stenosing tenosynovitis, as mentioned in the context of tendon abnormalities that can be diagnosed or confirmed by US evaluation 1.
- Splinting: to rest the finger and reduce movement, which can help alleviate symptoms.
- Ultrasound (US) evaluation: can be used to diagnose or confirm stenosing tenosynovitis, as well as to guide injections and monitor treatment progress 1.
Additional Considerations
In cases where non-surgical treatments are not effective, surgical options may be considered, although the provided evidence does not discuss surgical treatments in detail. It is essential to note that the evidence provided focuses on the use of US evaluation for diagnosing and confirming tendon abnormalities, including stenosing tenosynovitis, rather than discussing treatment options in detail 1.
From the Research
Treatment Options for Trigger Finger
- Conservative treatment options for trigger finger include:
- NSAIDs
- Hand splints
- Corticosteroid injections
- Physical therapies, such as external shock wave therapy (ESWT) and ultrasound therapy (UST) 2
- Surgical treatment options for trigger finger include:
- Open surgery
- Percutaneous surgery
- Endoscopic surgery 3
- Patient preference for treatment options:
- Observation (37% of participants)
- Splinting (27% of participants)
- Corticosteroid injection (19% of participants)
- Surgery (16% of participants) 4
- Treatment strategies for adult and pediatric trigger finger:
- Adult trigger finger: activity modification, splinting, corticosteroid injections, percutaneous A1 pulley release, and open A1 pulley release
- Pediatric trigger thumb: open A1 pulley release
- Pediatric trigger finger: release of the A1 pulley with excision of a slip or all of the flexor digitorum superficialis if triggering persists 5
- Outcomes of steroid injection and open trigger finger release:
- Recent steroid injection may be associated with postoperative surgical infections
- Older age, decreasing days between steroid injection and surgery, smoking, use of preoperative antibiotics, and use of lidocaine with epinephrine are risk factors for postoperative trigger surgical infections 6
Comparison of Treatment Options
- Open surgery versus steroid injections:
- Open surgery may provide benefits with respect to less triggering recurrence, although it has the disadvantage of being more painful 3
- ESWT and UST:
- ESWT is an effective and safe therapy for the conservative management of trigger finger
- UST has proven to be useful to prevent the recurrence of trigger finger symptoms 2