Needle-Free Jet Lidocaine Administration for Preinjection Anesthesia in Trigger Finger Injection: A Randomized Controlled Trial

J Hand Surg Am. 2017 Aug;42(8):618-622. doi: 10.1016/j.jhsa.2017.05.001. Epub 2017 May 24.


Purpose: To evaluate the efficacy of needle-free jet lidocaine (J-tip) administration for pain reduction in trigger finger corticosteroid injection compared with simultaneous lidocaine injection with corticosteroid.

Methods: A prospective randomized clinical trial was performed in which patients received either 0.25 mL of 2% lidocaine administered by J-tip just prior to 0.5 mL of corticosteroid injection by needle or 0.5 mL of 1% lidocaine and 0.5 mL of corticosteroid administered simultaneously through a needle for the treatment of trigger finger. Both the expected pain preinjection and the actual pain experienced postinjection were measured with a visual analog scale (VAS). Pain catastrophizing scale (PCS) scores were recorded before injection.

Results: The use of the J-tip demonstrated a lower mean actual pain, 3.3 VAS, compared with the control group, 4.6 VAS. Both study groups anticipated more pain than they actually experienced. The PCS did not correlate to pre- or post-injection scores.

Conclusions: Needle-free jet administration of lidocaine reduces the pain associated with trigger finger injection. Patients anticipate more pain than they experience with trigger finger injection.

Type of study/level of evidence: Therapeutic I.

Keywords: Trigger finger; corticosteroid; injection; randomized controlled trial.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anesthetics, Local / administration & dosage*
  • Female
  • Glucocorticoids / therapeutic use
  • Humans
  • Injections, Jet
  • Lidocaine / administration & dosage*
  • Male
  • Middle Aged
  • Pain Measurement
  • Pain, Procedural / diagnosis
  • Pain, Procedural / prevention & control*
  • Prospective Studies
  • Triamcinolone / therapeutic use
  • Trigger Finger Disorder / drug therapy*


  • Anesthetics, Local
  • Glucocorticoids
  • Triamcinolone
  • Lidocaine