What is the evidence for corticosteroid injections for trigger finger?
AMSTAR Rating
Summary
Patient Population:
5 RCT’s with 293 patients with a diagnosis of trigger finger (snapping or locking of a finger or thumb with or without pain, generally occurring in the palm level of the MCP joint).
Intervention:
Corticosteroid injection (triamcinolone or betamethasone) into tendon sheath
Comparison:
Lidocaine alone, or in comparison to Dexamethasone or a subcutaneous injection at same site.
Outcome:
- Corticosteroid (TA) and Lidocaine v. Lidocaine alone (2 RCT’s)
- Short term (4 weeks): Moderate evidence in favour to steroid and lidocaine
- Mid-term: No statistical difference
- Triamcinolone v. Placebo (1 RCT)
- Short term (1 week): Moderate evidence in favour of Triamcinolone
- Triamcinolone v. Dexamethasone (1 RCT)
- Short term (6 weeks): Limited evidence in favour of Triamcinolone
- Mid-term (3 months): No statistical difference
- Intra-tendon sheath v. subcutaneous injection
- Long term (27 months): No statistical difference
Guideline Recommendations
| Source | Recommendation |
|---|---|
| European HANDGUIDE | Moderate Evidence |
Outcomes Assessed
- Benefit
- Harm
- Inconclusive
Steroid v. Placebo
Pain (Short term)
Steroid and Lidocaine v. Lidocaine alone
Pain (Short term)
Pain (Mid-term)
Triamcinolone v. Betamethasone
Pain (Short term)
Pain (Mid-term)
Intra-tendon sheath v. subcutaneous
Pain (at 27 weeks)
Relevant Clinical Info
Ultrasound-guided steroid injection provides NO BENEFIT in treating trigger finger. Level II evidence. (J Hand Surg Eur Vol. 2019 Apr 4)
Participant Information
the sample size was 293
their were 5 studies used.
