Trigger Finger: Treatment Options and Next Steps

Q: Trigger Finger: Treatment Options and Next Steps

Hello, Apuchun： Trigger finger, also known as tenosynovitis, occurs when the sheath surrounding a tendon becomes inflamed due to external factors, causing the tendon to get stuck in a rough sheath. <br>This results in finger pain and an inability to bend or straighten the finger.

What is trigger finger and how is it treated?

Hello, Doctor.
I have trigger finger and saw a doctor about it.
Three days ago, I received injections in both fingers.
After the injections, my fingers were swollen for a few hours but the pain subsided.
However, three days later, the pain has returned.
What should I do? Should I get another injection? Thank you.

Apu, 50~59 year old female. Ask Date: 2003/01/01

Dr. Shi Guozheng reply Orthopedics

Hello, Apuchun: Trigger finger, also known as tenosynovitis, occurs when the sheath surrounding a tendon becomes inflamed due to external factors, causing the tendon to get stuck in a rough sheath.
This results in finger pain and an inability to bend or straighten the finger.
The usual cause is excessive use of the fingers, especially when they are used rapidly or repetitively in a short period, such as when cutting with scissors, gripping hard objects, or performing repetitive motions, which can lead to inflammation of the tendon sheath.
This condition can resolve on its own, provided that the inflamed or injured finger is given adequate rest; otherwise, it may recur even after receiving an injection.
The principle of treatment is to first reduce repetitive motions; eliminating the cause can lead to significant improvement.
Additionally, medications can be used to alleviate pain, and applying heat or soaking the fingers in warm water can help soften them for rehabilitation exercises.
If these measures are insufficient, corticosteroid injections may be considered.
Many studies have shown that corticosteroid injections are effective with minimal side effects, and it is safe to receive fewer than five injections within a year.
If you need further information, please refer to the orthopedic educational materials on the Hsinchu Hospital website at www.hch.gov.tw.
Wishing you health and happiness, and happy new year.
Dr.
Shih Kuo-Cheng, January 1, 2003.

Reply Date: 2003/01/01

More Info

Trigger finger, or stenosing tenosynovitis, is a condition that affects the tendons in the fingers, causing pain, stiffness, and a locking or catching sensation when trying to bend or straighten the affected finger. It can be particularly frustrating, especially when symptoms persist despite treatment.
In your case, it seems that you have already received corticosteroid injections, which are a common treatment option for trigger finger. These injections can help reduce inflammation and relieve pain, but they do not always provide a permanent solution. The fact that your finger swelled and then became painful again after a few days suggests that while the initial treatment may have provided temporary relief, the underlying issue may still be present.

Here are some treatment options and next steps you might consider:
1. Rest and Activity Modification: It’s crucial to give your finger some rest. Avoid activities that require repetitive gripping or grasping, as these can exacerbate the condition. If your work involves using your hands frequently, try to find ways to modify your tasks to reduce strain on your fingers.

2. Splinting: Using a splint to keep the affected finger in a straight position can help reduce symptoms. This is particularly effective if worn at night. A splint can limit movement and give the tendon time to heal.

3. Physical Therapy: Engaging in physical therapy can be beneficial. A physical therapist can guide you through exercises that promote flexibility and strength in the finger, which may help alleviate symptoms over time.

4. Corticosteroid Injections: If your symptoms persist, another corticosteroid injection may be warranted. These injections can be repeated, but it's essential to discuss the frequency and potential side effects with your physician.

5. Surgery: If conservative treatments fail to provide relief, surgical intervention may be necessary. Surgery typically involves releasing the constricted tendon sheath, allowing the tendon to move freely. This option is usually considered when other treatments have not been effective after a reasonable period.

6. Alternative Therapies: Some patients find relief through alternative therapies such as acupuncture or massage. While these methods may not be scientifically validated, they can provide symptomatic relief for some individuals.

7. Follow-Up with Your Physician: It’s important to maintain open communication with your healthcare provider. If your symptoms worsen or do not improve with conservative measures, a follow-up appointment is essential to reassess your condition and discuss further treatment options.

In summary, while corticosteroid injections can be effective for many patients with trigger finger, they do not always provide a long-term solution. A combination of rest, splinting, physical therapy, and possibly further injections or surgery may be necessary to achieve lasting relief. Always consult with your healthcare provider to determine the best course of action tailored to your specific situation.

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