Trigger finger, or stenosing tenosynovitis, is a common hand condition. It is characterized by a catching, snapping, or locking sensation when attempting to bend or straighten an affected finger or the thumb. This interference significantly impacts daily activities, leading many people to seek alternatives to conventional treatments like steroid injections or surgery. This article examines the causes of trigger finger and evaluates the role of acupuncture as a therapeutic option.
What Causes Trigger Finger
Trigger finger develops due to a mechanical mismatch between the flexor tendon and its surrounding sheath, specifically at the A1 pulley. This pulley is a band of tissue that holds the tendon close to the bone, allowing for smooth gliding as the digit moves. The condition involves the thickening and inflammation of the tendon and the narrowing of the A1 pulley sheath, which restricts the tendon’s movement.
When the finger attempts to extend, the thickened tendon or a nodule cannot pass smoothly through the constricted pulley, causing the catching or locking sensation. Repetitive and forceful gripping activities are commonly associated with the onset, though the cause is often unknown. Underlying health issues, such as diabetes mellitus, rheumatoid arthritis, and hypothyroidism, also increase the risk of developing trigger finger.
Clinical Evidence for Acupuncture Treatment
A growing body of clinical research suggests that acupuncture is a viable, non-surgical treatment option, particularly for patients with mild to moderate trigger finger symptoms. Systematic reviews and controlled trials have demonstrated acupuncture’s effectiveness in reducing both pain and the mechanical severity of the condition. Outcomes are frequently measured using tools like the Visual Analog Scale (VAS) for pain and the Quinnell grade for snapping severity, both of which show significant improvement following treatment.
Some studies have compared acupuncture and related techniques, such as acupotomy, against conventional treatments like corticosteroid injections. These analyses have indicated that acupuncture interventions can be more effective than non-specific conventional treatment in improving overall clinical outcomes. Research into acupuncture performed directly at the impaired A1 pulley site has shown immediate and progressive improvements in pain and snapping severity, sometimes after just the first few sessions.
Acupuncture offers an alternative for those who cannot or choose not to undergo steroid injections or surgery, as it is associated with a low risk of adverse events. While some studies have limitations, the evidence consistently points to acupuncture as a beneficial modality for improving mobility and reducing discomfort. This makes it a promising choice for individuals seeking to avoid invasive procedures or manage chronic symptoms.
How Acupuncture Addresses Tendon Inflammation
Acupuncture influences the body’s healing processes through several physiological mechanisms that directly target the pathology of trigger finger. The insertion of fine needles into specific local points around the tendon sheath stimulates a neurophysiological response. This stimulation helps to modulate local inflammation by triggering the release of anti-inflammatory agents and reducing localized swelling in the constricted A1 pulley area.
The treatment also promotes improved microcirculation to the affected flexor tendon and its sheath. Increased blood flow delivers vital nutrients and oxygen while facilitating the removal of metabolic waste products that accumulate in inflamed tissue. Additionally, acupuncture stimulates the central nervous system to release naturally occurring pain-relieving chemicals, such as endorphins, which effectively reduce the perception of pain associated with finger movement. This combined action helps restore the smooth gliding mechanism necessary for normal finger function.
What to Expect During Treatment
An acupuncture session for trigger finger typically involves the insertion of very fine, sterile needles into specific points. Needles are often placed locally around the affected A1 pulley in the palm, targeting the area of maximum tenderness and thickening. The practitioner may also use distal points on the hand, wrist, or forearm, such as LI4 (Hegu) or PC6 (Neiguan), to maximize pain-relieving and circulatory effects.
Patients commonly feel a sensation known as “De Qi” upon needle placement, often described as a dull ache, heaviness, or slight electrical sensation, confirming therapeutic stimulation. Needles are generally retained for 25 to 30 minutes, sometimes receiving manual rotation or electrical stimulation to enhance the effect. A typical course involves sessions scheduled one to two times per week, with improvements often observed after a few sessions, though a full course may involve up to 18 treatments depending on severity.