Ultrasound-Guided Cortisone Injections for Trigger Finger

Introduction

Trigger finger, also known as stenosing tenosynovitis, is a condition that affects the movement of the fingers or thumb. It occurs when the flexor tendons in the hand become irritated and thickened, making it difficult for the tendon to glide smoothly through its sheath. This can lead to stiffness, pain, and the characteristic “catching” or “locking” sensation when trying to bend or straighten the affected finger.

At Joint Injections, we provide ultrasound-guided cortisone injections as one of the treatment options offered by our clinicians. This technique allows for precision and accuracy in delivering cortisone to the affected area.

Anatomy of the Finger and Tendons

The human hand is a complex structure made up of bones, joints, muscles, ligaments, and tendons. The flexor tendons, responsible for bending the fingers, run along the palm side of the hand and are held in place by fibrous pulleys. These pulleys form a tunnel-like sheath that keeps the tendons close to the bones, enabling efficient finger movement.

In a healthy hand, the tendons glide smoothly through these sheaths as the fingers bend and straighten. However, in trigger finger, the tendon sheath becomes narrowed or thickened, interfering with tendon movement.

Pathology of Trigger Finger

Trigger finger develops when the flexor tendon becomes inflamed or swollen. Over time, nodules may form within the tendon itself, further restricting its movement through the sheath. When this happens, the tendon may “catch” during movement, resulting in the finger locking in a bent position before suddenly straightening with a snap — much like pulling and releasing a trigger.

The condition can range from mild stiffness and occasional catching to severe cases where the finger becomes fixed in a bent position.

Causes and Risk Factors

Trigger finger can affect anyone, though certain factors increase the likelihood of developing the condition:

  • Repetitive hand use — frequent gripping or repetitive movements can strain the tendons.
  • Medical conditions — associations are noted with conditions such as diabetes and rheumatoid arthritis.
  • Age and gender — it is more common in people between 40 and 60 years old and is observed more frequently in women.
  • Trauma or injury — previous hand injuries may increase susceptibility.

Symptoms of Trigger Finger

The symptoms of trigger finger often begin gradually and may worsen with time if not addressed. Common symptoms include:

  • Pain and tenderness at the base of the affected finger or thumb.
  • Stiffness, especially in the morning.
  • A clicking or popping sensation during movement.
  • Finger locking in a bent position before snapping straight.
  • In severe cases, inability to straighten the finger at all.

Diagnosis of Trigger Finger

Diagnosis is typically made during a clinical assessment. A clinician will examine the hand, assess range of motion, and palpate the affected area to identify tenderness and nodules. Imaging is rarely required but may be used to rule out other conditions.

Management of Trigger Finger

The management of trigger finger can vary depending on severity. Options include:

  • Rest and activity modification — reducing repetitive gripping or strain.
  • Splinting — immobilising the affected finger to allow tendon rest.
  • Hand therapy — stretching and strengthening exercises guided by a clinician.
  • Injections — cortisone injections are frequently used to target inflammation at the tendon sheath.
  • Surgical intervention — in severe or persistent cases, surgical release of the pulley may be considered.

At Joint Injections, we focus on the use of ultrasound-guided cortisone injections for precision treatment of trigger finger.

Ultrasound Guidance in Cortisone Injections

Ultrasound guidance allows clinicians to visualise the tendon sheath in real time during the injection procedure. This provides several advantages:

  • Accurate delivery of cortisone into the targeted area.
  • Reduced risk of injecting into surrounding structures.
  • Improved safety and comfort for patients.
  • Confidence for both patient and clinician in achieving correct placement.

Cortisone Injections for Trigger Finger

Cortisone is a type of corticosteroid used to address inflammation. When injected into the tendon sheath, it works locally to reduce swelling and irritation of the tendon, allowing smoother movement.

At Joint Injections, cortisone injections are performed using ultrasound guidance to ensure accuracy and precision. This approach allows the clinician to clearly identify the inflamed area and deliver the medication directly to the site of concern.

Mechanism of Action of Cortisone

Cortisone works by interrupting the inflammatory process within the tendon sheath. The mechanism includes:

  • Reduction of inflammatory mediators — cortisone decreases the production of chemicals responsible for inflammation.
  • Decreased swelling — less swelling allows the tendon to move more freely within its sheath.
  • Relief of pressure — by reducing inflammation, cortisone lowers mechanical stress within the tendon sheath.
  • Improved tendon movement — with reduced inflammation, the tendon glides more smoothly, helping to ease the catching or locking sensation.

Why Choose Joint Injections for Trigger Finger

Joint Injections offers a specialist service focused on precision-guided treatments for musculoskeletal conditions. For trigger finger, our clinicians utilise real-time ultrasound imaging to ensure cortisone injections are placed with accuracy and care.

The emphasis is on patient comfort, precise treatment, and a tailored approach to individual needs. By combining expertise in musculoskeletal conditions with advanced imaging technology, Joint Injections provides a considered and thorough pathway for those seeking treatment for trigger finger.

Conclusion

Trigger finger can significantly affect hand function, making everyday tasks uncomfortable and frustrating. Understanding the anatomy, pathology, and symptoms of the condition highlights the importance of accurate diagnosis and management.

At Joint Injections, ultrasound-guided cortisone injections are part of the treatment pathway provided by experienced clinicians. With an emphasis on precision, care, and tailored treatment, patients with trigger finger are offered a pathway designed around their condition and needs.

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