Trigger Finger and Shockwave Therapy

🎥 Chapters
0:01 Trigger Finger: From Painful Pops to Full Recovery
0:19 Extracorporeal Shockwave Therapy for Trigger Finger
0:41 Understanding Trigger Finger: Causes and Symptoms
1:17 Rest, ice, splinting, and exercises – traditional treatment methods for Trigger Finger
1:31 Shockwave Therapy (ESWT): A Breakthrough in Trigger Finger Treatment
2:37 Research on Shockwave Therapy for Trigger Finger
4:01 Extracorporeal Shockwave Therapy versus Corticosteroid Injections for Trigger Finger Treatment
5:50 Shockwave Therapy as a non-invasive option promoting regeneration for Trigger Finger
6:16 Connection between Trigger Finger and Carpal Tunnel Syndrome

Trigger Finger and Shockwave Therapy

Extracorporeal Shockwave Therapy (ESWT) is a good option to decrease pain and catching of trigger finger. Also called Stenosing Tenosynovitis, Locking Finger or even Trigger Thumb this, very irritating, condition can be helped with shockwave therapy.  Research on the effectiveness of ESWT is solid. Now pair it with specific stretches and exercises for trigger finger and you have a path to recovery.

How does shockwave therapy help trigger finger?

With trigger finger, there is inflammation and narrowing of the sheath surrounding the tendons in the fingers or thumb. This sheath is called the A1 pulley. It is like a tunnel that the tendon goes through at the base of the finger on the palmar side of your hand. This narrowing can cause the affected finger to become locked in a bent position, making it difficult to straighten. ESWT from the Piezowave machine delivers low-energy focused shockwaves to the affected area. Here it breaks up brittle adhesions on the tendon and the A1 pulley.  After that, new blood is brought to the area via angiogenesis.  This is how growth factors are delivered to the area and unnecessary inflammation from tendonitis, or tenosynovitis, is ushered away.  As a result there is tissue regeneration or new collaged formation in the damaged tendon and sheath. The gliding function of the tendons improves which ultimately alleviates the symptoms of trigger finger.

ESWT offers a conservative treatment option for individuals with trigger finger who may not be candidates for surgery or prefer to avoid invasive procedures. By delivering targeted shockwaves to the site of inflammation, ESWT minimizes the risk of complications associated with surgical interventions while still achieving meaningful improvements in symptoms and function. This makes ESWT particularly suitable for individuals with mild to moderate trigger finger who are looking for a safe and effective alternative to surgery.

ESWT represents a valuable treatment option for individuals suffering from trigger finger. By promoting tissue healing, reducing inflammation, and improving tendon gliding function.

What to do for your trigger finger in addition to shockwave therapy.

Rest is your friend with trigger finger.  Play detective and know the activities that flare up your symptoms and avoid them.  This will stop the re-aggravation cycle and give your body time to enlist its wonderful recuperative abilities.

People often wake up with symptoms. Wearing a splint at night to keep the affected finger in a straight position can help rest the tendon and reduce locking.  The more we keep your finger from locking, the quicker it will heal.  Even a figure-8 brace can be used during the day to partially limit movement.  The key is to have as much of your normal movement as possible without having your finger lock.

We, also, give rehab exercises and encourage them to be done along with the care in the office. Besides ESWT, stretching the muscles and carefully strengthening the hand we recommend the A1 pulley stretch.  The A1 pulley stretch is performed by applying an isometric contraction to the tip of your locking or catching finger with the finger straight but flexed at the MP joint at 45°.  This stretch was studied and published in the journal BMC Musculoskeletal Disorders. The study is titled,  “Evaluation of the first annular pulley stretch effect under isometric contraction of the flexor tendon in healthy volunteers and trigger finger patients using ultrasonography.”

What not to do for your trigger finger.

Some people choose to get a cortisone shot for their trigger finger.  Injecting corticosteroids into the tendon sheath can reduce inflammation and swelling, providing relief from symptoms.  However, cortisone is destructive to the tendon and other structures of your finger. This can set the stage for weakness in the infrastructure of your tendons, ligaments and even bone.  They cause what is called, “chondrocyte apoptosis”. This is a killing of the cells that make collagen.  How important is collagen? Collagen provides structural support to the extracellular space of connective tissues, this is vital to regeneration and tissue normalization. Due to its rigidity and resistance to stretching, it is the perfect matrix for skin, tendons, bones, and ligaments Corticosteroids destroy collagen and shockwave therapy helps build new collagen. For this reason, shockwave therapy falls under the category of regenerative medicine.

We have shockwave therapy in Los Gatos and San Jose.

You can reach Dr Fields for in-person (Los Gatos and San Jose, California) or telehealth appointments here.

 

SHOCKWAVE THERAPY AND TRIGGER FINGER RESEARCH

*Outcomes of the treatment of trigger digits by extracorporeal shock wave therapy (ESWT) https://pubmed.ncbi.nlm.nih.gov/32135551/
ESWT is an effective therapy for trigger digits in II° i III° severity grade and may be an alternative for other, noninvasive measures such as physiotherapy or steroid injection.
*The Effect of Extracorporeal Shock Wave Therapy in the Treatment of Patients with Trigger Finger https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7069581/
Extracorporeal shock wave therapy leads to a reduction in pain severity, severity of triggering, and functional impact of triggering.
*Extracorporeal Shockwave Therapy in the Treatment of Trigger Finger: A Randomized Controlled Study https://pubmed.ncbi.nlm.nih.gov/34029555/
Conclusions: ESWT is a safe and effective alternative facilitating pain relief and functional improvement in the treatment of grade II TF
*Extracorporeal shock wave therapy versus corticosteroid injection in the treatment of trigger finger: a randomized controlled study https://pubmed.ncbi.nlm.nih.gov/26763271/