Tendinitis of the Wrist – Symptoms of Inflammation of the Tendon Sheaths and Tendovaginitis of the Hand and Wrist

The official term for tenosynovitis (ICD code M65) is

• synovitis,
• tenosynovitis, or
• tendovaginitis.

It is an inflammatory process within the so-called tendon sheath.

Tendons connect bones to muscle tissue. Wherever tendons are subjected to particularly high stress, they run through protective tendon sheaths. These sheaths are lined with synovial fluid. Tendon sheath inflammation refers to an inflammatory change in this tendon sheath tissue.

During repetitive and/or excessive strain, the tendons rub against the inner wall of their tendon sheath. As a result, the sheath swells, causing the tendon channel to become increasingly narrow. If the tendon is not consistently relieved of strain at this point, the friction intensifies. This leads to an ever-increasing narrowing of the tendon sheath.

Tendinitis is caused in most cases by overuse. Athletes are therefore particularly at risk—especially those who play tennis or golf. Also

• construction workers,
• moving helpers,
• massage therapists,
• cashiers, and
• people who work at a computer

are more likely than average to develop tendonitis. In some occupational groups, tendonitis is even officially recognized as an occupational disease.

Other causes of tendonitis include:

• underlying medical conditions (such as rheumatism)
• Infections (for example, Lyme disease)
• Injuries
• Hormonal fluctuations (during pregnancy, menopause)

Tendinitis of the wrist. Source: Wikipedia

Medium-sized to large joints are most commonly affected by tenosynovitis. The wrist and thumb are particularly at risk. Inflammation of the tendon sheaths also frequently occurs in the shoulder and foot.

The condition is accompanied by severe pain, which is initially noticeable only during movement.

If the tendon sheaths in the ankle are inflamed, every step becomes difficult and athletic activities are no longer possible. Later, the pain also occurs at rest and at night. Swelling and redness may also develop.

In cases of tendon sheath inflammation in the wrist, severe pain occurs when moving the hand upward toward the forearm. The so-called “snapping sensation” is also typical of tendon sheath inflammation, especially when the forearm and/or elbow are affected.

Golfers suffer from tendonitis of the shoulder at a higher-than-average rate. The pain is particularly severe when the arm is moved upward.

If you rest the affected area promptly, the symptoms often subside on their own after three to five days. If this does not happen, you should see a doctor.

Prompt treatment is very important for tendonitis to prevent the condition from becoming chronic. Your primary care physician can be your first point of contact. If necessary, they will refer you to an orthopedist or a sports medicine specialist.

Usually,

• a detailed medical history,
• range-of-motion tests, and
• palpation of the affected area

to diagnose tenosynovitis. However, if there is any doubt, the doctor may also order an ultrasound examination (sonography).

An X-ray is not necessary, as the bones are not affected by tendonitis. However, an X-ray can be informative if treatment is not working or if other conditions need to be ruled out.

If the inflamed areas need to be visualized as precisely as possible, an MRI is the method of choice.

If a rheumatic disease is suspected as the cause of the tenosynovitis, a blood test is performed. This allows certain laboratory values to be checked.

Tendinitis is primarily treated by consistently resting and immobilizing the affected area. This immobilization can be achieved through

• bandages,
• splints, or
• wraps

. It is also helpful to apply cold to the painful area—especially if it is red, warm, and/or swollen.

In cases of very severe symptoms, pain-relieving ointments or tablets may be used. Injections of cortisone and locally acting pain relievers are also an option. However, these medications are only used when the pain is extremely severe and significantly impacts the patient’s quality of life.

Cooling ointment helps relieve pain caused by tenosynovitis © motorolka / Fotolia

In cases of chronic tenosynovitis, surgery is often the last resort. During the procedure, either the inflamed portion of the tendon sheath is completely removed, or the narrowed area is incised to relieve pressure.

If another condition is causing tenosynovitis—such as rheumatism—that condition must also be treated. 

Some home remedies have proven effective in treating tenosynovitis and can therefore be used to complement medical treatment, such as:

• Horse ointment
• Mud packs
• Arnica ointment
• Healing clay
• Caraway oil
• Cold quark compresses

Provided the patient rests the affected area, tenosynovitis heals within a few days without complications.

Chronic tenosynovitis, on the other hand, lasts several weeks or even months. It recurs repeatedly.

There are many simple ways to effectively prevent tenosynovitis.

Perform stretching exercises even at the first sign of discomfort while working or exercising. This relaxes the muscles and keeps ligaments and tendons supple.

Also, take regular breaks—especially during very repetitive tasks.

If you spend several hours a day working at a keyboard, it’s advisable to use a keyboard that’s as flat as possible and a special keyboard pad. However, make it a habit to stretch and move your wrists frequently throughout the day. An ergonomically shaped mouse is also recommended. To relieve strain on your “mouse finger,” you should also use keyboard shortcuts instead of the mouse from time to time.

Tennis and golf players, as well as climbers, are best advised to wear support wraps while playing or climbing. For tradespeople, there are ergonomically designed tools that significantly reduce the risk of developing tendonitis.

Tendinitis is usually caused by repetitive movements, overexertion, or working at a computer, and it frequently affects the hand and wrist. Among the most common causes of tendonitis are improper strain on the tendon and tendon sheath, which can cause the tendon sheath to become inflamed and swollen, resulting in sharp pain. The flexor tendons of the fingers, the elbow, and the wrist are particularly commonly affected. One form of tenosynovitis is De Quervain’s tenosynovitis, also known as trigger finger.

A physical examination and early diagnosis are important for identifying tenosynovitis and preventing its recurrence. If tenosynovitis is suspected, various treatment options can help, such as rest, anti-inflammatory medications, or physical therapy. In rare cases, tendonitis is caused by an infection, which requires specific treatment. Often, tendonitis can be treated without surgery and heals well with consistent rest.

It is also important to be able to prevent tenosynovitis. This includes ergonomic measures such as using an ergonomically designed mouse, taking regular breaks, and performing exercises to improve tendon glide. Especially in cases of discomfort in the hand or wrist, early intervention is crucial to prevent the condition from becoming chronic. The prognosis for tenosynovitis is generally good in most cases if the condition is detected and treated in a timely manner. Tenosynovitis of the hand, in particular, can usually be successfully alleviated through appropriate load management and targeted therapy.

What is tenosynovitis?

Tendovaginitis is an inflammation of the tendon sheaths, in which the sheath becomes inflamed and may swell. Tendovaginitis is often caused by overuse, repetitive movements, or irritation of the tendon and joint. The hand and wrist are particularly affected.

What are the symptoms of tendon sheath inflammation?

Typical symptoms include sharp pain, swelling, limited mobility, and discomfort during activity. Often, the affected tendon and the surrounding tendon sheaths become inflamed in the area of the thumb or forearm. In De Quervain’s tendovaginitis, pain occurs particularly in the thumb.

How is tenosynovitis treated?

Treatment options include rest, anti-inflammatory medications such as ibuprofen, immobilization, and physical therapy. In severe or chronic cases, a procedure or surgery may be necessary. The goal is to reduce inflammation and restore mobility.

How can you prevent tenosynovitis?

Tendinitis can be prevented through ergonomically designed workstations, regular breaks, and stretching exercises. Especially when working at a computer, an ergonomically designed mouse helps reduce strain and friction on the tendon. Repetitive movements should also be avoided as much as possible.

When should you see a doctor if you suspect tendonitis?

If you experience severe pain or swelling, or if the tendonitis in your wrist does not subside, you should seek medical attention. A physical examination can help determine whether the condition is infectious tendonitis or another disorder, such as trigger finger or stenosing tenosynovitis.