Stenosing tenosynovitis, commonly known as trigger finger, is a condition where a finger or thumb gets stuck in a bent position, or “catches,” when straightened. This mechanical obstruction occurs because the flexor tendon becomes inflamed and develops a nodule, making it too large to glide smoothly through the narrow A1 pulley tunnel at the base of the finger. A corticosteroid injection is a common and effective non-surgical treatment aimed at reducing this localized inflammation and swelling within the tendon sheath. The steroid medication works directly at the site of the problem to shrink the inflamed tissue, thereby restoring the necessary space for the tendon to move freely.
The Expected Timeline for Relief
The relief from a steroid injection is typically gradual, not immediate, because the medication requires time to fully reduce the inflammation. While the local anesthetic mixed with the corticosteroid provides initial numbness, the therapeutic effect of the steroid takes longer to begin. Many patients report the first noticeable reduction in pain within the first week following the injection. Pain relief often occurs before the mechanical symptoms of catching or locking resolve. On average, patients experience complete relief from pain within about 6.6 days, and resolution of the triggering sensation takes approximately 8.1 days. The peak therapeutic benefit is usually reached within one to three weeks, resulting in significant or complete symptom resolution.
Factors Influencing Recovery Speed
The speed and success of the injection can vary significantly based on several factors unique to the patient and the condition. A primary factor is the severity and duration of the trigger finger; less severe cases or those present for a shorter period tend to respond more quickly and favorably. If the finger has progressed to becoming permanently locked, the response may be slower or less complete. Underlying health issues also play a significant role, as patients with conditions like diabetes often experience lower success rates and a slower recovery timeline. Furthermore, the specific type of corticosteroid used can influence the outcome. The precision of the injection, ensuring the medication is accurately delivered into the flexor tendon sheath, also contributes to a faster and more effective response.
Immediate Care Following the Procedure
After receiving the injection, it is common to experience a temporary increase in discomfort, sometimes called a steroid flare, which can last up to 72 hours. This short-term soreness is a reaction to the medication itself and should not be mistaken for the injection failing. Applying ice to the injection site for short intervals and taking over-the-counter pain relievers, such as acetaminophen or ibuprofen, can help manage this temporary discomfort. Patients should use the treated hand for light activities immediately but are advised to avoid strenuous gripping or heavy lifting for the first few days. Limiting “power gripping” for about three weeks is often recommended to reduce stress on the tendon and allow the inflammation to subside fully.
Options If Symptoms Persist or Return
A single corticosteroid injection provides a long-term solution for many individuals, with the duration of relief often lasting six months to over a year. However, symptoms may persist if the initial inflammation is too severe, or they may return over time. Recurrence rates have been reported in some studies, with the average time to recurrence being about 312 days.
If the initial injection fails to provide adequate improvement after several weeks, or if the symptoms return after a period of relief, a second injection is often considered. Physicians typically recommend waiting at least three months between injections into the same finger to avoid potential complications. If a patient fails to find resolution after two or possibly three injections, the next step is usually a surgical procedure.
Surgical Options
Surgical treatment, known as trigger finger release, is a highly effective option that permanently resolves the mechanical issue in nearly all patients. This procedure involves a small incision to cut the constricted A1 pulley, which immediately creates more room for the tendon to glide without catching. The surgery can be performed as an open procedure or a less invasive percutaneous release, offering a long-term solution when non-surgical methods are no longer successful.