Diabetes lessens effectiveness of corticosteroid injections for trigger finger

Corticosteroid injections into the flexor tendon sheath for the management of trigger finger are more effective in patients who do not have diabetes mellitus (DM) than in those who do. Patients without DM are significantly more likely to avoid surgery.

Baumgarten and colleagues conducted a prospective, randomized, controlled, double-blind study of 59 patients with trigger finger. Patients with DM were randomized into a corticosteroid or placebo group. Those in the corticosteroid arm were injected with a mixture of betamethasone sodium phosphate/acetate solution and lidocaine. Patients who had partial relief or recurrence of symptoms received second and third injections.

After 1 or 2 injections, 25 (86%) of the 29 digits in the non-DM group had a successful outcome, compared with 12 (63%) of 19 in the DM corticosteroid group and 8 (53%) of 15 in the DM placebo group. No significant difference was found between the DM groups. Surgery was performed in 3 digits in the non-DM group, compared with 7 and 6 in the DM corticosteroid and DM placebo groups, respectively.

The authors noted that corticosteroid injection is a sound, lowrisk primary treatment option for trigger finger in patients with DM, as well as in other patients.