Management of Finger Sprain

Initial Management

The American College of Sports Medicine recommends applying functional support with buddy taping to the adjacent finger, beginning early active range-of-motion exercises within 48-72 hours, and using NSAIDs or acetaminophen for pain control while avoiding prolonged immobilization 1, 2

Apply ice for 20-30 minutes per application to reduce pain and swelling, using ice and water in a bag surrounded by a damp cloth, without direct skin contact to prevent cold injury 1
Use NSAIDs (ibuprofen, naproxen, or diclofenac) for pain and swelling control, as they are equally effective as opioids but with significantly fewer side effects 2
Acetaminophen is equally effective as NSAIDs for pain, swelling, and range of motion if NSAIDs are contraindicated 2
Avoid prolonged immobilization beyond 10 days, as this leads to worse functional outcomes compared to early mobilization 2

Buddy taping is the preferred method for finger sprains, and should be continued for 4-6 weeks during activities to provide stability while allowing joint motion 2, 3
Begin active range-of-motion exercises as soon as tolerated (typically 48-72 hours), starting with gentle flexion and extension exercises multiple times daily to maintain joint mobility 2, 3
Progress to strengthening exercises focusing on grip strength and individual finger strength once pain allows, and include proprioceptive training to restore coordination and prevent recurrent injury 3

Allow return to protected activity with buddy taping once pain-free active range of motion is achieved, and continue buddy taping during sports for 4-6 weeks to prevent recurrent injury 2, 3
Full unrestricted activity can resume when grip strength is restored and the joint is stable without support 3

The British Journal of Sports Medicine recommends against using RICE (Rest, Ice, Compression, Elevation) as the sole treatment, as it has no positive influence on pain, swelling, or function when used alone 3, 4
Do not immobilize in a rigid splint for more than 10 days unless there is a specific indication, as prolonged immobilization causes worse outcomes 2
Do not prescribe opioid analgesics, as they provide no better pain relief than NSAIDs but cause significantly more adverse effects 2