Intrasynovial Digital Anesthesia in Trigger Finger
NCT Number: NCT06476977
Status: RECRUITING
Study Type: INTERVENTIONAL
Phases: NA
Conditions: Trigger Finger Disorder
Interventions: PROCEDURE: Dorsal webspace combined corticosteroid and anesthetic injection|PROCEDURE: Palmar combined corticosteroid and anesthetic injection
Sponsor: Kevin Zuo
Sex: ALL
Age: ADULT, OLDER_ADULT
Enrollment: 60
Study Design: Allocation: RANDOMIZED|Intervention Model: PARALLEL|Masking: NONE|Primary Purpose: TREATMENT
Start Date: 2024-07-03
Completion Date: 2026-07
Locations: University Health Network - Toronto Western Hospital, Toronto, Ontario, M5T 2S8, Canada

Summary:
Trigger finger is a common disease of the hand involving swelling and inflammation of the tendon which flexes a finger, causing catching, locking, and/or pain. Trigger finger is typically treated by hand surgeons with a steroid injection through the front/palm side of the hand into the area near the tendon (i.e., at the base of the affected finger). This steroid injection is often combined with a local anesthetic (numbing agent) to help reduce short-term pain from the injection. However, the front/palm side of the hand is known to be very sensitive, and the steroid injection can be quite painful as the needle pierces the front/palm skin.

To reduce the pain of steroid injections for trigger finger, a different approach involves performing the injection from the back/dorsal side of the hand, which is thought to be less sensitive (and therefore less painful) than the front/palm side of the hand. This technique is sometimes used and has been previously studied, but it is not clear if it can offer less injection-related pain than standard treatment.

Accordingly, this study will be comparing short-term injection-associated pain between front/palm side and back/dorsal side steroid injections for trigger finger. The study will also seek to understand what area of the hand is numbed by the anesthetic when doing a front/palm side injection versus a back/dorsal side injection of the hand. Overall, the investigators hypothesize that back/dorsal side injections will be less painful than front/palm side injections for trigger fingers and that the area of numbing from the anesthetic will be equivalent between both types of injections.

Primary Outcome Measures: Visual Analogue Scale (VAS) - Pain, 100mm mechanical rating scale for pain, ranging from 0mm ("no pain") to 100mm ("pain as bad as it could be"); higher scores indicate a worse outcome., measured at 0 hours, 4 hours, and 24 hours post-injection|Numerical Rating Scale (NRS) - Pain, 11-point numerical rating scale for pain, ranging from 0 (no pain) to 10 (worst pain ever possible); higher scores indicate a worse outcome., measured at 0 hours, 4 hours, and 24 hours post-injection|Short-Form McGill Pain Questionnaire (SFMPQ) - Present Pain Intensity (PPI), 5-point combined numerical-word rating scale for pain, ranging from 1 (mild) to 5 (excruciating); higher scores indicate a worse outcome., measured at 0 hours, 4 hours, and 24 hours post-injection
Secondary Outcome Measures: Sensory Assessment - Light Touch, Semmes-Weinstein 2.0g monofilament test as threshold of sensory impairment, measured at 0 hours post-injection|Sensory Assessment - Pain, Pinprick pain sensation with an 18-gauge sharp needle tip, measured at 0 hours post-injection