Why does stenosis tenosynovitis of the fingers snap? This starts with the relationship between the tendon and the tendon sheath. Each long tendon is tightly constrained by the tendon sheath where it stretches or flexes across the joint. This restraint acts as a strong barrier for the tendon to prevent it from ejecting in the direction of the flexion of the joint and from sliding to the sides. It's like a long rope that is firmly attached to the bone as it crosses the joint.
The tight binding of the tendon sheath and the bone forms a bone-fibrous tunnel with minimal elasticity. This tunnel is like a one-way street, allowing only the tendons to slide steadily in it. And the edge of the tendon sheath, like the edge of a road, is sharp. Not only do they prevent the tendon from moving too much, but they also help keep the tendon in the correct position. However, when the tendon sheath becomes inflamed and narrows, this otherwise tight bone-fibrous tunnel begins to become crowded. The tendon cannot slide freely in it, and the slightest movement can get stuck in the narrowing of the tendon sheath. It's like being on a narrow side road, and the slightest deviation from the vehicle will hit the side of the road. Each time the tendon tries to pass through the tendon sheath, it rubs against the narrow tendon sheath, creating a snap. Therefore, the reason why tenosynovitis of the fingers with stenosis produces snapping is that the inflamed tendon sheath becomes narrow, so that the tendon cannot slide freely in it, and the slightest movement will rub against the tendon sheath and produce a snapping sound. This is a mechanism for the body to protect itself, reminding us to restore the normal function of the fingers in time. 
Figure 8-6 Finger flexor tendon tendon and tendon sheath.
The cause of the snapping of stenosis tenosynovitis of the fingers actually involves a series of complex pathological changes. When our tendons rub hard for a long time and continuously, it can cause tenosynovitis and tendonitis. These two types of inflammation can lead to chronic damaging inflammation of the tendon and tendon sheath, such as edema, hyperplasia, hyaline, and adhesions. Edema and hyperplasia of the tendon sheath narrows the fibrous tunnels, resulting in fusiform enlargement, which undoubtedly impedes the normal sliding of the tendon. This phenomenon is particularly evident at the beginning of the flexor tendon fiber sheath corresponding to the metacarpophalangeal joints of the middle and ring fingers, and at the annular sheath of the sesamoid bone and ligaments at the metacarpophalangeal joint on the thumb side. When an enlarged tendon tries to pass through a narrow tunnel of bone fibers, a plucking action is created that is accompanied by a crisp snapping sound. Therefore, for stenosynovitis with snapping, the key to acupuncture** is to alleviate the edema and hyperplasia of tendons and tendon sheaths, restore their normal form and function, and thus eliminate snapping. [Figure 8-7].
Acupuncture** tendonitis works by cutting through thickened and hardened fibrous sheaths, and sometimes even induration on tendons, to unclog adhesions between the tendon and tendon sheaths. The purpose of this process is to unblock the narrow bone-fiber tunnel and thus eliminate the spring. In this way, patients can effectively relieve pain and improve range of motion. During the needle knife** procedure, the doctor uses a knife similar to a needle and inserts it through a tiny incision into the lesion. By manipulating the needle, the surgeon can precisely cut through the fiber sheath and induration, thereby releasing the adhesions between the tendon and the tendon sheath. This method is very popular because it is less invasive to the patient and has a short recovery period. It is important to note that acupuncture** is not suitable for all patients with tendonitis. For some patients with milder symptoms, conservative** may be more appropriate. For patients with more severe symptoms, a more aggressive** approach, such as surgery, may be required. Therefore, patients should fully understand their condition and have a full discussion and evaluation with their doctor when choosing the best regimen. (Figure 8-8).
February** Dynamic Incentive Program