Trigger finger, medically known as stenosing tenosynovitis, is a condition characterized by pain, stiffness, and a locking or catching sensation in the affected finger or thumb.
The typical medical treatment for trigger finger (stenosing tenosynovitis) usually starts with the least invasive options and progresses to more invasive interventions:
1. Conservative Treatments(non-intrusive options)
- Rest and Activity Modification: Reducing or avoiding activities that aggravate the condition, especially repetitive gripping or grasping.
- Splinting: Wearing a finger splint (usually at night) to keep the affected finger in a straight position, allowing the tendon to rest.
- Nonsteroidal Anti-inflammatory Drugs (NSAIDs): Medications like ibuprofen or naproxen can help relieve pain and reduce inflammation.
- Stretching and Physical Therapy: Gentle exercises to improve range of motion and reduce stiffness.
- Ultrasound Therapy or Iontophoresis can also be used to relieve the symptoms.
2. Corticosteroid Injections
- A corticosteroid is injected directly into the tendon sheath at the base of the affected finger (Because fingers have a lot of nerve endings, this option is a more painful treatment)
- This is often very effective, especially in early or moderate cases. Many patients experience relief within a few days to weeks.
- In some cases, a second injection may be required if symptoms return.
3. Surgical Treatment
- Percutaneous Release: A minimally invasive procedure where a needle is used to release the tight portion of the tendon sheath.
- Open Surgical Release: In more severe or persistent cases, a small incision is made in the palm to cut the sheath and release the tendon.
- Surgery is typically outpatient and has a high success rate, though it comes with standard surgical risks and a recovery period.
Alternative Treatments
- Acupuncture is used to relieve the symptoms and reduce the need for surgery .
Traditional treatments range from rest, splinting, steroid injections, to surgery. However, acupuncture is a promising complementary treatment for trigger finger, offering a range of advantages with fewer side effects.
One key advantage of acupuncture is its ability to reduce pain and inflammation without the need for pharmaceutical intervention. By targeting specific points on the body, acupuncture stimulates blood flow and promotes the release of endorphins and anti-inflammatory chemicals, helping to ease tension and swelling in the affected tendon sheath. This natural pain relief can be especially beneficial for individuals seeking to avoid corticosteroid injections or long-term medication use.
Another benefit of acupuncture is its holistic approach. Rather than focusing solely on the symptoms in the hand or finger, acupuncture considers the body’s overall energy flow (Qi) and addresses any underlying imbalances that may contribute to the condition. This systemic perspective can support broader healing and may even help prevent recurrence of trigger finger symptoms.
Additionally, acupuncture is minimally invasive and generally well-tolerated. Unlike surgery, it requires no downtime and carries minimal risk of complications. For patients who are not ideal candidates for surgical intervention or who prefer non-invasive therapies, acupuncture can offer a gentle yet effective alternative for managing trigger finger.
As acupuncture needles are usually 1/100 the thickness of injection needles, the pain is minimized. Most cases, the acupuncture points needled for the treatment of trigger fingers are not on the fingers where typical injection or surgery is targeted (which causes much pain and patients typically need to rest for the day or several days before the finger is better again).
In our clinic, most patients can expect to be able to extend the finger by themselves after one or two acupuncture treatments without too much pain. The patient does not need any rest after the treatment and can use the hand and finger immediately afterwards.
A sample case:
Patient, male, 75 years old, with trigger finger starting a month ago: first pain in the ring finger proximal phalanx thought to be arthritis, getting worse over 2 weeks, to the point when the patient closed the fist, the ring finger cannot open any more, and forcing it open caused tremendous pain. The primary care doctor diagnosed it as trigger finger, and the patient was given a splint to wear 24hrs/day to prevent the finger from bending. After 2 weeks of wearing the splint, the patient’s condition worsened, so the doctor recommended a hand surgeon for further treatment. While waiting to schedule the surgery, the patient’s pain worsened, affected daily functions, and also started to experience pain in the arms.
Patient had previous conditions that were treated with acupuncture with good results, so he called in to ask if acupuncture treatment could help. After receiving a positive answer, the patient came in and with one treatment, the patient regained complete range of motion, and the ring finger no longer had pain.
The patient was given a set of exercises and care instructions at home, no longer wore the splint during the day and wore it only at night because the patient was worried about the finger “sticking” again. At the second week follow up, the patient was no longer having any issues moving the finger and neither the finger or the arm having any pain.
In our clinic, most trigger finger cases can be significantly improved or completely resolved with 1-3 treatments and one follow up, the needles are almost 1/100 the thickness of injection needles and in most cases, the needle does not need to go in the affected finger (which is most painful to needle) to treat this condition.
The acupuncture treatment of trigger finger is one of the fastest to resolve pain and improve the range of motion for trigger finger even in the most severe cases. It can also help to reduce the cases needing surgery, and the patient can use the hand immediately after treatment without lengthy recovery time.
