Hand and Wrist Tendonitis

What is Hand and Wrist Tendonitis?

Tendonitis is the swelling and irritation of a tendon caused by an injury or overuse. Hand and wrist tendonitis can lead to weakness, inflammation, swelling, and pain in the hand or wrist. Two common problems associated with hand and wrist tendons are inflammation of a tendon, and tenosynovitis, which is the inflammation of the lining of the tendon sheath. 

Common Types of Hand and Wrist Tendonitis

The most common forms of hand and wrist tendonitis are: 

• DeQuervain’s Tenosynovitis. The most common type of tenosynovitis disorder, which causes pain and swelling in the tendon sheath of the tendons in the thumb.

• Trigger finger or trigger thumb. A type of tenosynovitis where the tendon sheath becomes inflamed and thickened, making it hard to bend or straighten the finger or thumb. The finger or thumb may lock or “trigger” suddenly. 

Hand and Wrist Tendonitis Causes

The cause of tendonitis and tenosynovitis is often not known, but they are usually caused by strain, overuse, injury, or repetitive movements. Tendonitis may also be related to conditions such as:

• Diabetes
• Gout
• Rheumatoid arthritis
• Thyroid issues
• Infection

Symptoms of Hand and Wrist Tendonitis

Aside from pain and swelling, you may experience the following symptoms of hand and wrist tendonitis:

• Reduced strength
• Inability to bear weight
• Stiffness
• Muscle fatigue and cramping
• Tearing, popping, or snapping
• Bruising and warmth

How is Hand and Wrist Tendonitis Diagnosed?

First, your doctor will conduct a physical examination and review your medical history. They will check for:

• Tenderness by applying pressure to the hand, wrist, and forearm
• Flexibility and range of motion 
• Swelling and/or bruising in the wrist, hand, or forearm

Then, your doctor will ask you questions about your injury, such as the onset of pain and other symptoms, trauma or injury to the wrist area, the occurrence of muscle spasms or cramps in the forearm or hand, and decreased strength in the hand. If more information is needed, your doctor may order specific tests to confirm the diagnosis:

• Finkelstein’s test. This test includes making a fist with the fingers covering the thumb and then bending the wrist toward the little finger. Pain on the thumb side of the wrist is an indication of tendonitis in the wrist area. 

• Ultrasound. An ultrasound can be performed at different angles of the wrist. This test provides good details of the affected tendons and their surrounding soft tissues. 

• MRI. An MRI of the wrist is performed when the doctor wants to evaluate the tendons as well as their surrounding structures, such as bones and cartilage. 

Treatment for Hand and Wrist Tendonitis

Nonsurgical Treatment

In most cases, nonsurgical treatments can be used to promote healing in hand and wrist tendonitis. Patients typically recover from tendonitis injuries in a few days to weeks, depending on the severity — some chronic cases may take up to two months. Nonsurgical treatments for hand and wrist tendonitis include:

• Immobilization. Placing the hand and wrist in a splint or brace is usually the first treatment step. By resting the tendon, the inflammation should decrease.

• Rest. Applying ice to the affected area for 20-minute intervals can help to minimize swelling and stimulate blood flow to the area of tendonitis.

• Anti-inflammatory medication. Over-the-counter medication, such as aspirin and ibuprofen, will help to relieve symptoms of pain, but also decrease inflammation and swelling of the soft tissues. 

• Hand therapy. Hand therapists use many techniques from stretching and strengthening exercises to electrical stimulation and ultrasound. In addition, a hand therapist will often fabricate custom splints and supports to help control movements of the hand and wrist. 

• Cortisone injection. Cortisone is a more powerful anti-inflammatory treatment option, given by injection to the site of inflammation.

Surgery

If other treatment methods have failed to provide relief from symptoms for 3 to 6 months, surgery may be required to treat hand and wrist tendonitis. The surgery is typically performed under local anesthesia and your surgeon will make a small incision in your hand, wrist, or finger to locate and repair the damaged tendon. 

However, if the tendon damage is more complex, the procedure may be carried out under general anesthesia. Since the procedure is minimally invasive, patients are allowed to go home the same day, experience a quicker recovery time, and have a lower risk of side effects and complications. 

Hand and Wrist Experts at Raleigh Orthopaedic

At Raleigh Orthopaedic Clinic, our hand surgeons work closely with our on-site Certified Hand Therapists to treat a wide range of hand and wrist injuries and conditions, including tendonitis. We will make sure you understand each step of your care plan and answer any questions you have along the way. Contact us today to learn more or schedule an appointment at one of our convenient locations in Wake County.