Seventy-six patients with trigger finger were randomized to receive either a corticosteroid injection alone (n = 38) or a corticosteroid injection combined with 1% lidocaine (n = 38). The primary outcome was injection-related pain assessed via a numerical rating scale. Secondary outcomes included failure to resolve symptoms by 6 weeks, defined as persistent symptoms, need for a second injection, or surgery. Outcomes were measured at injection, 1 hour, 6 hours, 2 days, and 6 weeks post-injection. Overall, the results of the study revealed significantly less pain during injection (4.6 vs 6.2) and at 1 hour (1.3 vs 2.5) in the lidocaine group, but the differences did not exceed the predefined clinically meaningful threshold. At 6 weeks, failure rates were similar (21% vs 18%). These findings suggest no clinically important benefit of adding lidocaine to corticosteroid injections for trigger finger.