This is one of the most common causes of hand pain. This is also referred to as stenosing tendovaginitis or tenosynovitis and is associated with thickening of the tendon or the retinacular sheath in which the tendon slides. The tenosynovium is a very fine and thin layer of tissue almost like a elly which covers the tendons allowing smooth gliding within the sheath. The tendons pass through fibro-osseous canals or sheaths on the back of the wrist (dorsum) as well as on the palmar side of the hand. They provide fulcrums for the acute angulation of these tendons. These canals are narrow and during this constant motion, there can be swelling and bunching of the tendon fibres which can lead to a restriction of gliding and finally catching or locking of the tendon. This process leads to an acute inflammatory response with resultant edema and thickening of the retinacular sheath. There are thickened areas within the sheath called pulleys. This process most commonly occurs at the first of such thickenings called the A1 pulley.
Did you know!
Though triggering can occur both on the palmar as well as the dorsum or back of the hand, the phrase ‘trigger finger’ is most commonly used to refer to its occurrence on the palmar or flexor surface of the hand