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Investigating a No-Cost, Noninvasive, Patient-Driven Approach to Pain Reduction for Trigger Finger Injections - A
Aidan Crislip1, Gabriel Garcia2, Spencer Stanbury3
1Grand Canyon University, Phoenix, AZ; OrthoArizona, Gilbert, AZ.
The Journal of Hand Surgery
|April 30, 2025
Summary
Patient-controlled scratching in the same skin area as the trigger finger injection significantly reduced pain. This tactile stimulation method proved more effective than cognitive distraction alone for managing injection pain.
Area of Science:
- Pain Management
- Musculoskeletal Disorders
- Dermatology
Background:
- Trigger finger (stenosing tenosynovitis) is a common condition often treated with corticosteroid injections.
- Injection pain can be a significant deterrent for patients, impacting treatment adherence.
- Current pain management strategies for injections are varied, with ongoing research into effective, non-pharmacological methods.
Purpose of the Study:
- To investigate the efficacy of patient-controlled scratching within the relevant dermatome for reducing pain during corticosteroid injections for trigger finger.
- To compare this tactile stimulation method against a control group (no scratching) and a cognitive/motor distraction group.
Main Methods:
- A prospective, single-blind, randomized controlled study involving 105 patients with trigger finger.
- Patients were allocated to three groups: control, distraction (contralateral scratching), and experimental (ipsilateral dermatomal scratching).
- Pain was assessed using the Visual Analog Scale (VAS) before and after the injection, with the Pain Catastrophizing Scale (PCS) also administered.
Main Results:
- The experimental group (ipsilateral dermatomal scratching) showed a statistically and clinically significant reduction in experienced pain (VAS 28) compared to the control group (VAS 59).
- The distraction group also reported less pain (VAS 43) than the control group, but more than the experimental group.
- Only the experimental condition demonstrated a significant reduction in experienced pain relative to anticipated pain.
Conclusions:
- Patient-controlled scratching of the skin within the same cervical dermatome as the trigger finger injection site effectively reduces pain.
- Tactile stimulation in the relevant dermatome is a more effective pain reduction strategy than purely cognitive distraction for corticosteroid injections.
- This technique offers a promising, non-pharmacological approach to improve patient comfort during trigger finger injections.
