Trigger finger: US guided combined dry needling and steroid injection provides better long term results than non-guided steroid injection

Abstract Background Trigger finger (stenosing tenosynovitis) is characterized by restricted finger motion, snapping, or locking due to hypertrophy and inflammation of the A1 pulley, impairing flexor tendon gliding. Treatment options include rest, splinting, corticosteroid injections, and surgical release. This study compares the clinical effectiveness of ultrasound (US)-guided A1 pulley combined dry needling and corticosteroid injection versus non-guided (blind) corticosteroid injection for trigger finger. Methods Thirty patients with clinically diagnosed trigger finger were recruited from an orthopedic hand clinic and randomized into two groups: US-guided injection (Group A, n = 15) or non-guided injection (Group B, n = 15). Both groups received a corticosteroid and local anesthetic mixture. Group A injections were performed under US guidance and were preceded by dry needling. Clinical effectiveness, defined as restoration of normal finger motion (Quinnell grade 0 or 1), was evaluated at 1 week, 2 weeks, 1 month, and 6 months post-injection. Results No statistically significant differences in clinical improvement between the two groups were observed at week 1, week 2 and 1 month follow ups. However, at 6-months, Group A demonstrated a significantly higher response rate, with 93% (14/15) of patients reporting restored finger motion (Quinnell grade 0 or 1) compared to 47% (7/15) in Group B (chi-square test, p < 0.05). No significant adverse events were reported in both groups. Conclusions US-guided dry needling and corticosteroid injections for trigger finger yield superior long-term clinical outcomes compared to non-guided steroid injections, despite comparable short-term results. These findings support the use of US guidance and dry needling to enhance the precision and efficacy of trigger finger treatment.