In the hand, flexor tendons that help the hand close the fingers into a fist posture, travel through special tunnels as they traverse from the palm to the fingertips. The tendon and the tunnel usually have a perfect fit relationship. Any inflammation in the hand from things such as heavy repetitive use of the hands can cause inflammation and swelling in and around the tendons and upset the perfect tendon/tunnel balance. When this happens, friction and pain begin to develop at the entrance to the tunnel as the tendon attempts to squeeze its way into the tighter tunnel entrance. The patient first experiences pain and stiffness in the involved finger, then true locking of the fingers and a flexed position develops. This locking or “triggering” leads to a significant elevation of pain and disability.
Treatment of trigger finger tendonitis involves two options. Steroid injection of the base of the finger at the tunnel entrance usually offers prompt, predictable relief of triggering and pain in patients with recent onset of symptoms. In patients with longstanding pain and triggering, a simple outpatient surgical procedure to open the tunnel entrance usually permanently solves the triggering problem.
