Focused Extracorporeal Shock Wave Therapy (ESWT) Versus Traditional Physiotherapy in the Treatment of Trigger Finger

Cheng-Hsin General Hospital

Overview

Trigger finger is the common name of stenosing tenosynovitis of fingers, caused by repetitive trauma. Conservative treatment includes NSAIDs or other analgesic agents, activity modification, splint, and physiotherapy. Operation could be considered if conservative treatments fails. With literature reviewed, there is no treatment which is both non-invasive and effective, and also could avoid recurrence well. Extracorporeal shock wave therapy could induce angiogenesis, anti-inflammatory reaction, and recruitment of fibroblast. Although extracorporeal shock wave has been utilized in musculoskeletal diseases for more than twenty years, there is no well-designed clinical trial to prove the effectiveness of extracorporeal shock wave in treating trigger finger. The purpose of this study is to compare the effectiveness of extracorporeal shock wave therapy with traditional physical therapy for the management of trigger finger.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Conditions

Trigger Finger Stenosing Tenosynovitis

Interventions

Eligibility

Sex: ALLMin age: 18 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Quinnel classification grade 2 or 3 * who has only one trigger Exclusion Criteria: * who had ever treated the trigger finger * who has other musculoskeletal disease of the upper limb * who has severe coagulopathy disease * who is pregnant * who has arrhythmia or has a pacemaker * there is sensory impairment, scar, edema at the trigger finger * who has cognitive dysfunction

Outcomes

Primary Outcomes

Quinnell stages of triggering

Quinnell stages of triggering classifies the trigger finger using five types during flexion and extension: normal movement (Type 0), uneven movement (Type I), actively correctable (Type II), passively correctable (Type III) and fixed deformity (Type IV).

Time frame: 15 weeks

11-point numeric scale of pain

The 11-point numeric scale of pain requires the patient to rate their pain on a defined scale. 0 is no pain and 10 is the worst pain imaginable.

Time frame: 15 weeks

Chinese quick DASH (disabilities of the Arm, Shoulder, and Hand questionnaire)

This questionnaire is a self-administered region-specific outcome instrument developed as a measure of self-rated upper-extremity disability and symptoms. The investigators chose the first two components: the disability and symptom section (11 items, scored 1-5). The lower score means better condition of upper limbs, and vice versa.

Time frame: 15 weeks

strength of hand grip

The strength of hand grip is to measure the maximum isometric strength of the hand and forearm muscles by a electicial grip strength device.

Time frame: 15 weeks

sonographic image

The investigators would record the characteristics of acquired sonographic images, such like the thickness of finger flexor tendon and A1 pulley, the presence of tendon sheath effusion, and the presence of increased vascularity by Doppler images.

Time frame: 15 weeks