Reduction in pain from corticosteroid injection for the treatment of trigger finger with subcutaneous single-injection digital block: a randomized controlled trial.

Abstract

The pain from corticosteroid injections is not an insignificant issue for patients with trigger finger. The aim of this study was to evaluate the efficacy of subcutaneous single-injection digital block (SSIDB) for pain reduction during trigger finger corticosteroid injection. Ninety patients requiring corticosteroid injections for trigger finger were randomized to three groups: SSIDB with 2ml of 1% lidocaine, SSIDB with 1ml of 1% lidocaine and no digital block (control group). In SSIDB groups, the intrasynovial corticosteroid injections were performed after digital nerve block. In control group, ethyl chloride spray was applied prior to intrasynovial injection of the corticosteroid and 1% lidocaine mixture. The pain during lidocaine needle insertion, lidocaine infiltration, corticosteroid needle insertion and corticosteroid infiltration were determined with a visual analog scale (VAS). The VAS pain scores for corticosteroid needle insertion in both SSIDB groups were significantly lower than the VAS pain scores in control group (p < 0.001). The VAS pain score during corticosteroid infiltration in 2ml of 1% lidocaine group was significantly lower than 1ml of 1% lidocaine group (p = 0.008), and in control group (p < 0.001). Pain during nerve block procedure in both SSIDB groups was significantly lower than the pain from corticosteroid injection in the control group (p < 0.05 and p < 0.05). Subcutaneous single-injection digital block with 2ml of 1% lidocaine was highly effective in reducing pain associated with injection of corticosteroid for trigger finger.