What are tendons?
Tendons are strong, flexible bands of tissue that connect your muscles to your bones. You can find them throughout your body. Tendons range in size from the smallest one in your inner ear to the large ones in your legs. When these tendons become inflamed and irritated, it's called tendonitis.
Tendonitis in the wrist usually occurs as De Quervain's tendonitis. This type of tendonitis primarily occurs from overuse. It causes pain at the back of the wrist and base of the thumb. While it's usually a result of overuse, it can sometimes appear in pregnancy, or for no clear reason.
What is tendonitis in the wrist?
Two of the main tendons on the thumb go through a tunnel-like structure on the wrist. These tendons are covered by a thin, tissue-like lining called synovium. This layer allows the tendons to slide easily through the fibrous tunnel.
Any irritation or swelling of the tendons or synovium results in pain due to friction with movements of the thumb and wrist.
Symptoms of tendonitis in the wrist can include:
- Gradual or sudden pain over the thumb side of the wrist
- Wrist pain that travels up the forearm
- Pain that is worse when grasping something or twisting the wrist
- Swelling over the thumb side of the wrist
- Catching or snapping sensation when moving the wrist
- Difficulty with moving the thumb or wrist because of swelling
You can usually get tendonitis of the wrist because of overusing it. People who spend a lot of time grasping or pinching with the thumb are especially likely to develop De Quervain's tendonitis. However, it can also happen because of pregnancy or rheumatoid arthritis. It is most likely to occur in middle-aged women.
Diagnosis for tendonitis in the wrist
Your doctor will listen to your symptoms and perform a physical exam to diagnose your tendonitis. You may be asked questions about your pain, such as its location and intensity.
Your doctor will probably ask you to perform a test called the Finkelstein test. In this test you make a fist with your thumb inside your fingers and bend your wrist toward your little finger. This test will be painful for people with De Quervain's tendonitis, but remember that you need a diagnosis to figure out your course of treatment.
Treatments for tendonitis in the wrist
Your treatment plan will focus on relieving the pain caused by the swelling and irritation. Some treatment options include:
The medicines you might normally expect to receive are:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) to help relieve the swelling and pain. These can be taken by mouth or injected directly into a tendon compartment
- Corticosteroid injections into the tendon sheath
- Antibiotics if your tendonitis is from an infection
Your doctor may recommend the following measures:
- Splints to rest the thumb and wrist
- Changing activities to avoid doing anything that might cause pain
- Ice or a cold compress to cut inflammation and pain
Most cases of tendonitis of the wrist will not need surgery. However, if your symptoms are severe and do not improve with other treatments, your doctor may suggest surgery. In this surgery, called De Quervain's release surgery, your doctor will open the sheath over the inflamed tendons.
People who have office jobs will need to take a few weeks off to recover. People who work in jobs that involve heavy manual labor will need about 6 weeks off before returning to work.
Regardless of which treatment option you use, you will probably be able to resume normal use of your hand once your symptoms go away and you regain your strength.
Possible complications and side effects
Depending on the course of treatment, there are different possible side effects. If your doctor chooses to give you nonsteroidal antiinflammatory drugs, you may find:
- Stomach ulcers
- Allergic reaction
- In rare cases, liver, kidney, or heart problems
If you doctor puts you on a course of steroid injections, some side effects you could have include:
- Pain around the injection site for a few days
- Loss of fat around site of injection
- Increased blood sugar level if you have diabetes
- Increased blood pressure if you have high blood pressure
- Infection that causes redness, swelling, and pain
There are always risks in surgery, which makes it the last option for treating wrist tendonitis. Though they aren’t common, some complications can include:
- Nerve or blood vessel injury
- Tendon movement
- Complex regional pain syndrome, about 5% of people develop a painful, swollen, and stiff hand
Talk to your doctor if you notice any of these side effects to figure out how to manage them.
Health Solutions From Our Sponsors
Cedars-Sinai: "Tendonitis and Tenosynovitis."
Harvard Health Publishing: "Tendonitis."
NHS: "Steroid Injections."
OrthoInfo: "De Quervain's Tendinosis."
Rebecca Ayers: "De Quervain's Tenosynovitis."
The Journal of Hand Surgery: "Tendon Disorders of the Hand and Wrist."
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