What Is Tendonitis?
Tendonitis is a condition in which the tissue that connects the bone to the muscle becomes inflamed or irritated. The stress on this tissue—called the tendon—can cause severe pain and make movement and function difficult or impossible. Tendonitis is commonly experienced in the hand, wrist, and forearm, making movements like grabbing and reaching difficult. Because these extremities are responsible for many necessary functions, living with tendinotis can prevent you from completing simple daily tasks and diminish your overall quality of life.
Hand (Trigger Finger)
Tendonitis of the hand is commonly referred to as “trigger finger” or “trigger thumb”—a condition marked by difficulty bending and straightening the fingers. This occurs when the tendon connecting the base of your finger and palm becomes swollen. While the exact cause of trigger finger is unknown, repetitive motions and forceful gripping has been known to cause tendon swelling in this area. Activities like playing an instrument, carpentry, gardening, or playing sports can increase the risk of tendinotis in the hand.
Once the tendons in fingers become swollen, forcing the finger to flex will often cause a popping or snapping sound. Other symptoms of tendinotis in the hand may include:
- Pain
- Fingers “catching” when moved
- Fingers locking
- Restricted finger movement
- Finger stiffness
- Joint contractures
Treatment
With comprehensive treatment, painless movement of the fingers and thumbs can be achieved. Many times, swollen tendons in the hand can be addressed with non-surgical options, such as:
- Night splints
- Anti-inflammatory medication
- Steroid injection
- Limiting activities that trigger symptoms
- Hand therapy
If less invasive methods of treatment do not address your symptoms, a surgical procedure can be performed by one of our New York hand surgeons to open up the tendon sheath (layer covering the tendon), allowing for easier movement and helping the tendons in your hand glide more freely. While some stiffness may occur after surgery, physical hand therapy can help this area regain proper function.
Wrist (De Quervain’s Tendinosis)
When tendons on the thumb side of the wrist become swollen, the condition is commonly known as De Quervain’s tendinosis. The swelling of tendons in this area can make many thumb movements—such as grasping and twisting—very painful. While the cause of De Quervain’s tendinosis is generally unknown, the condition is often linked to overuse, repetitive motion, hormonal changes caused by pregnancy, and rheumatoid disease. Common symptoms may include:
- Gradual or sudden pain in the thumb side of the wrist
- Visible swelling in the area
- The thumb “catching” or “snapping” when moved
- Limited thumb mobility
Treatment
Treatment for tendinotis in the wrist can work to reduce the pain and irritation of the condition. Many non-surgical options have been known to address symptoms; however, in some cases, surgery may be necessary if there is no improvement or symptoms worsen.
- Non-surgical—Wearing a splint can prevent you from moving your thumb and wrist, alleviating the pain of swollen tendons in that region. Anti-inflammatory pain medication can also effectively improve symptoms. The most common initial treatment for De Quervain’s is a steroid injection into the affected area.
- Surgical—In some cases, surgery can open the thumb compartment to make more room for swollen tendons to pass through. If less invasive methods don’t help, your doctor can help you determine whether surgical treatment would benefit you.
Forearm (Intersection Syndrome)
Intersection syndrome is a condition commonly associated with tendinotis in the lower forearm, usually a few inches from the wrist. Swollen tendons in this area can no longer glide easily, causing pain when flexing, extending, and rotating the forearm. Any athletic or general activity that involves repetitive wrist flexing can cause intersection syndrome. Common symptoms of the condition may include:
- Pain in the forearm
- Tenderness in the area
- Swelling
- A squeaking or creaking sound when moving the wrist
Treatment
A physical examination or ultrasound may be necessary to distinguish intersection syndrome from De Quervain’s tendinosis, but the location of pain is usually a good indicator of your condition. In general, non-surgical treatment for tendon swelling in the forearm may include:
- Wearing a splint to immobilize the lower thumb and wrist joints
- Anti-inflammatory medication
- Limiting activities that may aggravate symptoms
- Steroid injection to decrease swelling
If these methods fail to improve your symptoms, surgery may be recommended. Should this happen, our experienced reconstructive hand surgeons can determine the procedure that will most benefit you and create a treatment plan to address your unique needs. After surgery, physical hand therapy can help the area regain function, with full recovery generally expected in several weeks.
