What is Tenosynovitis?

Tenosynovitis is an inflammation of the tendon sheaths of the thumb and fingers of the wrist. Although this condition can affect other parts of the body as well, mainly the ankles and feet. It is simply more commonly seen in the wrist and fingers, however. The muscles of the forearm are responsible for movement of the thumb and fingers. They are attached to the bones of the thumb and fingers by tendons. These tendons are secured and firmly attached to the hand by running under what is called the tendon sheath. This sheath is a band of connective tissue that is located over the tendons and as well as firmly attaching them to the hand, the tendon sheaths contain synovial fluid which provides nourishment and lubrication to allow for smooth movement of the flexor tendons. The two most commonly known forms of Tenosynovitis are Trigger Finger and De Quervain’s Syndrome. Tenosynovitis significantly affects the function of the involved thumb or finger and can cause significant pain.

Causes of Tenosynovitis

Tenosynovitis is usually an overuse syndrome, resulting from repetitive motions over a period of time, but this condition can be caused by infections, traumas, or other insults to the body. Some causes and risk factors area:

● Repeated or new movements that stress the tendon, whether from a job, sports, or hobbies
● Infection in the area which can cause irritation and inflammation of the tendon
● A traumatic event is sometimes the cause of Tenosynovitis
● Previous fracture leading to a build-up of scar tissue in the area restricting movement
● Other health conditions can increase the risk of developing Tenosynovitis such as Rheumatoid Arthritis, Gout, Scleroderma, Diabetes, and gonorrhea
● Pregnancy and other condition that affect hormones

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Tenosynovitis Symptoms

Symptoms of Tenosynovitis will usually occur in the wrist and hands, but can occur at other places in the body. The symptoms may include:

● Stiffness of the joint
● Joint swelling and pain that increases with motion
● Feeling of locking or snapping when attempting to move the fingers and thumb
● Erythema, which is a reddening of the skin
● A low-grade fever might develop as the body’s attempt to fight infection

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Treatment for Tenosynovitis

The treatment for Tenosynovitis will be a collaborative decision between you and your doctor based on the location and severity of the condition. Non-surgical intervention will usually be successful in treating Tenosynovitis. These include:

● Rest
● Avoidance of any aggravating activities
● NSAIDs (nonsteroidal anti-inflammatory drugs)
● Topical anti-inflammatory medication
● Cortisone injections
● Physical or occupational therapy which will both help to teach proper ways to move and strengthen and    stretch certain muscle groups. Splint and braces may also be considered during physical or occupational therapy. Massaging the area in order to stimulate blood flow as well as TENS (transcutaneous electrical stimulation) which interrupts pain signals are also intervention you will be given in physical therapy.

When conservative measures fail to adequately reduce pain and improve function, surgical intervention may be necessary. The choice of surgery will involve making a small cut into the tendon sheath, allowing for more room in the area and restoration of a smooth, gliding motion.
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