A Comprehensive Approach to Chronic Trigger Finger: A1 Pulley Stretching and Dry Needling

Abstract

Trigger finger (TF) is a frequent condition that is more common in women in their fifth decade of life. It is caused by the trapping of the flexor digitorum superficial and flexor digitorum profundus tendons as they travel through fibro-osseous tunnels of the wrist, palm, and hand digits. This results in discomfort and stiffness, limiting daily activities. Corticosteroid injections are the first line of conservative treatment before surgery is performed. Physiotherapy has proven to be extremely effective in the treatment of trigger fingers. We described a 75-year-old woman who had persistent trigger finger pain and stiffness. Ultrasound, tendon gliding exercises, mobilization together with A1 pulley stretching, and dry needling were applied over a two-week period. Pre- and post-test scores of pains and activity limitation were obtained.
The findings showed that Pain scores decreased from 6 to 0 on the Nottingham Pain Rating Scale (NPRS) scale, and activity limitation decreased from 67.5 to 10.5% on the patient-rated wrist evaluation (PRWE) scale. Two innovative techniques that is the A1 pulley and dry needling along with ultrasound, tendon glide exercise, and mobilization are found to be effective in managing chronic trigger finger.