Question:I've had a painful and limiting trigger finger and thumb for about six months. The hand surgeon I'm seeing suggests it's time to inject the tendons. What does this do? Is it safe?
Answer:Steroid injection for trigger finger is a common and effective treatment for trigger finger (or thumb). A solution of steroid (antiinflammatory drug) and numbing agent such as lidocaine is injected into and around the tendon sheath. Swelling of the tendon sheath is reduced so that the tendon can glide through the covering smoothly.
Studies show that just one inection can resolve trigger finger for about half the patients. It may take a bit of time for the medication to be effective. So be patient with the process. Most patients find optimal results in about two to three months.
Some patients combine injection with hand therapy. Others have a repeat injection. Second or third injections are about half as effective as the first injection. If the trigger finger isn't helped by an injection or if it comes back after injection, then surgery to release the tendon sheath and pulley ligament holding the sheath in place may be needed.
It's not clear yet which method (or comination of treatments) works best. More research is needed in this area.David Ring, MD, PhD, et al. A Prospective Randomized Trial of Injection of Dexamethasone Versus Triamcinolone for Idiopathic Trigger Finger. In The Journal of Hand Surgery. April 2008. Vol. 33A. No. 4. Pp. 516-522.
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