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Wrist Tendonitis

What is wrist tendonitis?

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Updated April 02, 2014

Wrist tendonitis, also called tenosynovitis, is a common condition characterized by irritation and inflammation of the tendons around the wrist joint. Many tendons surround the wrist joint. Wrist tendonitis usually affect one of the tendons, but it may also involve two or more. Often wrist tendonitis occurs at points where the tendons cross each other or pass over a bony prominence.

The wrist tendons slide through smooth sheaths as they pass by the wrist joint. These tendon sheaths, called the tenosynovium, allow the tendons to glide smoothly in a low-friction manner.

When wrist tendonitis becomes a problem, the tendon sheath or tenosynovium, becomes thickened and constricts the gliding motion of the tendons. The inflammation also makes movements of the tendon painful and difficult.

What are the symptoms of wrist tendonitis?
The most common and consistent complaint of patients diagnosed with wrist tendonitis is pain over the area of inflammation. Swelling of the surrounding soft-tissues is also quite common.

How is the diagnosis of wrist tendonitis made?
Diagnosis of wrist tendonitis is a made by looking for the characteristic signs of this problem. In addition, depending on the tendon that is inflamed, the physician can perform tests that stretch the area of concern to locate the precise source of inflammation.

For example, one type of wrist tendonitis is called DeQuervain's tenosynovitis. This is inflammation of the tendon at the base of the thumb. Often seen in new mothers, DeQuervain's tenosynovitis is diagnosed by a specific test called 'Finkelstein's test' where the patient makes a fist and the wrist is pulled away from the thumb. Pain from this maneuver is diagnostic of this type of wrist tendonitis.

What is the treatment for wrist tendonitis?

  • Immobilization
    Placing the wrist in a splint or a cast is usually the first treatment step. Wrist tendonitis is due to recurrent irritation of the tendon and its sheath. By resting the tendon, the inflammation should decrease.

  • Ice the Injury
    Applying an ice pack intermittently to the area of inflammation may also be beneficial. Icing wrist tendonitis can help to cool inflammation and also stimulates blood flow to the area of tendonitis.

  • Anti-Inflammatory Medications
    Nonsteroidal anti-inflammatory medications will help control symptoms of pain, but more importantly they help in the treatment of wrist tendonitis to decrease inflammation and swelling of the soft-tissues. These treatment medications will decease the inflammatory response which is the cause of the pain.

  • Cortisone Injection
    Cortisone is a more powerful anti-inflammatory treatment option that is given by injection directly to the site of inflammation. Cortisone injections are safe, but can weaken tendons over time if too many injections are given.

  • Surgery
    Surgery is only done when these other treatment methods have failed to solve the problem. If that is the case, the area of tight tendon sheath that cause the painful and difficult tendon movements can be released. The inflammatory tissue can also be removed in an effort to create more space for the tendon to move freely.

Sources:

Almekinders, LC. "Tendinitis and other chronic tendinopathies" J. Am. Acad. Ortho. Surg., May 1998; 6: 157 - 164.

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