Review of Injection Treatment for Trigger Finger

What is the best treatment for trigger finger? How well do injections of steroids work? Is it better to just have surgery? These are the questions researchers at Vanderbilt University School of Medicine sort out by reviewing the medical literature on the subject of treatment for trigger finger.

Trigger finger is a condition in which a tendon gets stuck and no longer glides smoothly through its tunnel. Usually it's caused by a thickening of the protective sheath or cover around the tendon. The finger gets locked in a position of flexion or extension. The person with trigger finger reports pain and swelling to go along with the locked position.

Only studies with the highest level of evidence were included in this review. Random controlled trials (RCTs) using steroid injections as the main treatment were included. Only adults were studied. Follow-up of treatment outcomes were required.

Analysis of the data collected showed that women between the ages of 52 and 62 are most likely to develop trigger finger. These results confirm the results of previous studies. Fingers are affected 77 per cent of the time. The thumb is involved in about one-fourth of all cases.

One cortisone injection relieved symptoms in 47 to 87 per cent of the patients. But in one-quarter of those patients, the symptoms came back within a year's time. The authors suggest that cortisone may be helpful in the short-term but doesn't provide any long-term benefits.

Similar studies report an 89 to 100 per cent success rate with surgery. It may be that cortisone injection shouldn't be considered the first step in treatment. Although injection is effective in slightly more than half the patients, surgery has a much better track record for long-term success.

On the other hand, a single steroid injection is inexpensive and gives relief to a large number of people, therefore avoiding surgery.

Reference: 

Sheryl B. Fleisch, BS, et al. Corticosteroid Injections in the Treatment of Trigger Finger: A Level I and II Systematic Review. In Journal of the American Academy of Orthopaedic Surgeons. March 2007. Vol. 15. No. 3. Pp. 166-171.

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