Wrist Tendonitis Symptoms and Treatment

The thick and fibrous cords that connect muscles to bone are called tendons. A human body contains roughly about 4000 tendons, depending on the person’s size.

Whenever the suffix “itis” is added to a medical term, it means inflammation of that structure. Therefore, “Wrist Tendonitis” is nothing but inflammation of your wrist’s tendons due to any injury or repeated motion. Statistics show that Snowboarders are most prone to such wrist injuries.

In this write-up, I will talk about the causes, symptoms, prevention, and various treatment modalities of wrist tendonitis. But before I start with the inflammatory story of an injured tendon, let’s understand its anatomy.

Anatomy of Wrist Tendons

As discussed above, tendons are cords connecting muscles to the bones. The wrist tendons connect the muscles of our forearm to the bones of our hands and fingers.

When these wrist tendons pass through the wrist joint, they slide over them smoothly as tendons are enclosed in protective synovial sheaths. These tendon sheaths contain synovial fluid within the sheaths. Due to the presence of this lubricating fluid, the tendons glide whenever we move our wrists back and forth.

Inflammation of the tendon and its sheath is called tenosynovitis.
The tendons around the wrists are divided into the following two groups:

  • Extensors – those present at the back of the wrists
  • Flexors – those present at the front of the wrists

What Is Wrist Tendonitis?

A simple definition of wrist tendonitis would be “inflammation of the tendons surrounding the wrist.” As stated above, when the sheath is inflamed, it is known as tenosynovitis. Both the tendon and sheath can be inflamed at the same time.

Usually, the irritation and inflammation of the wrist tendons occur where the tendons cross each other over a bony prominence (any place where the bone is close to the human body’s surface). That ultimately leads to pain and discomfort while moving the affected joint.

What Are the Causes of Wrist Tendonitis?

The causes of wrist tendonitis may vary considerably depending on the specific conditions of the patient. It can be caused by inflammation, injury, or chronic damage.
Repeated movements of the wrist most commonly cause tendonitis such as:-

  • Texting
  • Writing
  • Using the computer for long hours
  • Playing video games works that require repetitive movements such as chopping, wood hammering, etc.
  • Physical work involving wrist movement
  • Sports such as tennis and badminton

Some of the other factors that also contribute to the risk of tendonitis are-

  • Poor wrist posture
  • Age
  • Any acute injury from a sudden blow or impact
  • Poor alignment of joints

Other causes are local and systemic diseases, such as gout, diabetes, or—autoimmune disease such as rheumatoid arthritis.

An important point to note is not to confuse tendonitis with wrist arthritis or Carpal tunnel syndrome. One condition can aggravate another, but still, they all are different entities.

  • Wrist Tendonitis is an inflammation of the wrist tendons.
  • Wrist Arthritis is an inflammation of the wrist joints.
  • Carpal Tunnel Syndrome is due to the compression of a nerve.

Symptoms

The first symptom that you observe when you wake up in the morning is pain and stiffness in your affected wrist. The affected wrist feels sore and tender on the touch.

You can also probably see some mild swelling.
Let’s go through the most common symptoms and then proceed to the less common ones.

The most common symptoms of wrist tendonitis are:

  • Pain that is dull but can worsen with movements
  • Discomfort
  • Inflammation
  • Redness
  • Joint stiffness
  • Tenderness

The other less common symptoms seen include:

  • A grinding sound or creaking when you move your wrist
  • Weakness in the wrist

The inflammation in your wrist can limit your hand motion. You experience weakness while performing simple routine motions such as typing, pinching, gripping, using a laptop or mouse, playing video games, texting, etc.

Types of Wrist Tendonitis

Wrist tendonitis is classified based on the type of tendons affected:

Extension Wrist Tendonitis

This condition develops when you constantly bend your wrists backward. Some of the examples of extension wrist tendonitis are:

  • Intersection Syndrome: A condition in which a group of four tendons present in the wrist is inflamed.
  • Extensor Carpi Ulnaris Tendonitis: Inflammation in the muscle that connects the outer side of your forearm to the fifth metacarpal bone of your hand (it helps to move the wrist towards your pinky finger

Flexion Wrist Tendonitis

This condition develops due to repeated forward bending of the wrist or Flexor carpi radialis tendonitis.

The most common types of hands and wrist tendonitis are:

  • De Quervain’s Tenosynovitis: This disorder results in pain and swelling in the tendon sheath present in the thumb’s tendons.
  • Trigger thumb or finger: a form of tenosynovitis where the tension sheath tendon sheet is inflamed, making it resistant to bending or straightening the finger or thumb.
  • Flexor carpi radialis tendonitis.

Risk Factors

Various factors can put a person at risk for wrist tendonitis:

Why Are the Tendons of the Wrists More Prone to Tendonitis?

Many reasons make the tendon surrounding the wrist more prone to injury such as sports, repetitive movements while doing work and accidents. Some of the contributing factors making wrist tendons more prone to tendonitis are listed below:

  • Blood Vessels
    Tendons have less blood supply than the muscles; therefore, if you perform any repeated movements such as playing longer sports, video games, or riding a bike, the tendon’s blood supply is drastically reduced. The reduced blood supply to the tendons of your wrist continuously can result in wrist tendonitis.
  • Nerves
    The small wrist tendons contain numerous nerve fibers involved in fine movements; hence, these tendons transmit more pain signals to the brain when affected compared to the larger ones.
  • Temperature
    When you continuously move your wrists, there is a 10% increase in the tendon’s internal temperature. Hence, temperature also plays a critical role in causing wrist tendonitis.

When to Seek Medical Attention?

If you have one or more of the above discussed potential risk factors, consider seeking medical advice.

Suppose you suspect any pain, discomfort, swelling, immobility, severe ongoing swelling, resistance to movement, or any tingling sensation in the fingers. In that case, these symptoms can indicate any bone fractures or nerve damage in your wrist.

In some cases, it can even progress and irritate an adjacent nerve causing carpal tunnel syndrome.

Clinical Tests

A professional can perform some specialized clinical tests to determine the inflamed wrist tendon’s location and severity.
The following are the clinical tests performed to evaluate the function and stability of the wrist tendons:

How Can I Prevent Wrist Tendonitis?

If you do not want to go through the excruciating pain and discomfort, then keep a note of the following points:

  • Avoid long hours of wrist movement like texting, household chores, writing, etc. Instead, take small breaks.
  • Before and after you use your wrist or hand, stretch them to maintain flexibility and warm up the muscles.
  • Infuse some joint protection methods in your daily routine.
  • Stop the activity as soon as you feel pain or any discomfort in the wrist or hand.
  • Regular follow-up with your health care professional if you have any systemic disease like arthritis, gout, etc.

Treatment of Wrist Tendonitis

In most cases, wrist tendonitis is successfully treated with non-surgical methods.
Usually, it takes around a few days or weeks to heal the tendonitis. However, when left untreated, it may become chronic and extend up to many months. Let’s first take a look at the non-surgical treatment modalities.

Non-Surgical Management

Immobilization

The first and foremost step to treat wrist tendonitis is to immobilize the wrist by either using splints, slings, straps or even a cast. Avoid using the wrist for long hours.
Incorporating small movements with intermittent rest can speed up the healing process.

Ice Therapy

Intermittent application of an ice pack on the affected wrist can tone down the inflammation and improve the blood flow to the wrist tendons.

Exercise

Instead of using heavy loads, try exercising with lighter loads and increasing the number of repetitions.

Eccentric exercises are proven to be beneficial for tendon healing. These types of exercises increase collagen production and decrease the temperature of the tendon.

Hand Therapy

There is a specialized therapy called hand therapy entirely focused on improving wrist function and stability. This therapy includes stretching and strengthening exercises, electric stimulation, and ultrasound.

These kinds of therapies are done under the guidance of occupational or physical therapists.

Drugs

The use of drugs to treat wrist tendonitis has always been controversial.
However, NSAIDs and steroids are used to relieve tendonitis pain and also to reduce inflammation and swelling.

On the other hand, some scientists believe that these drugs may delay tendons’ healing, ultimately worsening wrist tendonitis.

Cortisone injections are directly administered at the inflamed site. On the contrary, too many cortisone injections may weaken the tendons.

It’s important to note that these medications can have adverse effects on the stomach, kidneys, and heart when taken for the long term. Thus, doctors recommend not taking these drugs for more than 14 days.

Platelet-Rich Plasma Injection

In this method, the patient’s blood is drawn, concentrated, and administered again to the patient with an injection. The number of injections administered can vary depending on the severity of the tendonitis.

It contains growth factors stimulating the growth and healing of the tendons.

Extracorporeal Shockwave Therapy

In extracorporeal shockwave therapy, a series of shock waves are administered into the injured tendons that relieve the pain by preventing new nerves’ formation in the tendons.

A series of high and low energy shock waves are used in the therapy. Numb the area with the help of Local Anesthesia before administering the shock waves.

Depending upon the severity, one or more cycles of electric shock waves are administered to treat wrist tendonitis.

Surgical Methods

Indications

  • When non-surgical treatment modalities fail to treat the wrist tendonitis
  • Chronically degenerated wrist tendons (tendinosis)
  • When the wrist tendonitis progresses more than the 3-6 months

Objective

The inflamed tissues are surgically removed to create more space for the wrist tendons to move freely.

Surgical Procedures

Minimally Invasive Therapy

Needles and small tubes are used in the minimally invasive therapy. This therapy includes:

  • Tenotomy
  • Arthroscopic surgery

Open Surgery

A large incision is made on the skin overlying the affected wrist tendon. The various open surgical methods performed are-

  • Tendon sheath release
  • Tendon grafting
  • Tendon transfer
  • Tendon repair surgery
  • Tenosynovectomy

Possible Complications

  • Infection
  • Scar tissue formation
  • Stiffness in the wrist
  • Nerve damage

Healing

About 95% of the surgeries heal without any complications. Healing of the wrist tendonitis usually takes three to four weeks.

Wrapping Up

Most of us are going to experience wrist tendonitis at least once in our life. Try to prevent this by following some easy, simple tips. Consult a physician when you suspect any swelling in your wrists.

Let us know what you liked about this article in the comments section and share it with your friends and family who might need some quick tips to resolve their wrist tendonitis.

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