Injection Options for the Treatment of Trigger Finger: A Review of Current Literature

Introduction: Stenosing tenosynovitis of the flexor tendon, more commonly known as trigger finger (TF), is an ailment characterized by inflammation of the A1 pulley. This inflammation can eventually lead to pain and the inability to manipulate the digit. While surgical release is considered the gold standard for TF treatment, corticosteroid injection is often trialed before proceeding with surgery. It is an effective treatment for those who do not want to undergo surgery. This review aims to investigate the current literature regarding TF injection options and techniques to identify best practices and current gaps in research that warrant further investigation.  

Methods: A clinical review was conducted using the keywords “trigger finger,” “stenosing tenosynovitis,” “injection,” and “treatment.” Articles discussing surgical treatment or other pathologies aside from TF were excluded. Some articles outside the search parameters were included to provide scientific and clinical context.  

Discussion: There are several gaps in the current literature regarding TF treatment. Studies have shown that local anesthetic in conjunction with corticosteroid does not decrease pain associated with injection. This warrants an investigation into the continued use of local anesthetic with TF injections despite the known chondrotoxic effects. Studies have also shown mixed results regarding use of ultrasound-guided injections and long-term patient outcomes, which could benefit from repeat studies with larger sample sizes. Furthermore, the efficacy and cost-benefit of orthobioligic injectate options, such as platelet-rich plasma, require further research. Finally, further investigation of preventative treatments, such as osteopathic techniques, would benefit the field.