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What is trigger finger? This is a question I answer probably 10 times a day in an average clinic. It is easily the most common problem in hand surgery. The short answer is, it’s a tendonitis, or more specifically, a stenosing tenosynovitis, the tendons that flex your fingers. To understand trigger finger, you first have to understand how these tendons flex your fingers and the pulley system that they go through. Each finger has two sets of tendons, that help to curl or bend the fingers, except the thumb, which has one. These tendons begin as muscles in the forearm that then form tendons that pass through the carpal tunnel and into the palm. At the base of the fingers or the end of the palm, the pulley system begins, which is essentially a tunnel that the tendons pass through. These tunnels help to keep the tendons close to the bones of the fingers. This helps to increase their strength and their efficiency, so that the tendons work better. Normally the tendons glide smoothly in these tunnels, but for some reason, most commonly just bad luck, the tendons swell up, or the sheets of the pulleys stick in. This makes it harder for the tendon to pass through the tunnels, leading to the clicking and sometimes locking of the finger. Pain also develops as the tendon rubs on the sheet.
