Stenosing tenosynovitis is more commonly known as trigger finger or trigger thumb. It involves the pulleys and tendons in the hand. These tendons and pulley work together to bend the fingers. The tendons work like long ropes going from the muscles in the forearm to connect to the bones of the fingers and thumb. In the finger, the pulleys are a series of rings (made of connective tissue) that form a tunnel that the tendons must pass through. This is very much like the guides on a fishing rod through which the line (or tendon) passes. These pulleys hold the tendons close against the bone. The tendons and the pulley (tunnel) have a slick lining that allows easy gliding.
So the goal of treatment is to eliminate the catching or locking and allow movement without discomfort. To do this the swelling around the tendon must be reduced to allow smooth gliding of the tendon. Wearing a splint or taking anti-inflammatory medication by mouth or injection into the area around the tendon (a corticosteroid shot) are ways to reduce the swelling. Changing how the hand is used, better body mechanics to reduce the impact or repetitive motions helps. If nonsurgical forms of treatment do not improve symptoms, then surgery may be recommended. This surgery is usually performed on an outpatient basis. Most often it is done using local anesthesia, but a regional (where only the arm is numbed) or a general may be used. The surgery cuts the pulley (only one and the finger still has other pulleys to keep it near the bone) which gives the tendon more room to glide, removing the restriction (cutting the ring off the swollen finger). Active motion of the finger is generally begun immediately after surgery. Normal use of the hand can be resumed once comfort permits.