Tenosynovitis of the Wrist

What is Tenosynovitis of the wrist?

Tenosynovitis is an inflammation of the tendon sheaths in the wrist that encase the tendons for the thumb and fingers.  This condition can affect other parts of the body; however, it is simply more commonly seen in the wrist.  The movement of the fingers and thumb are controlled by the muscles of the forearm.  These muscles are attached to the bones of the thumb and fingers by thick, fibrous bands called tendons. Tendons connect muscle to bone and ligaments connect bone to bone.  Tenosynovitis of the wrist is a condition that affects tendons.  When the muscles in the front of the forearm contract and shorten, this pulls on the tendon which in turn pulls on the bones that they are attached too, hence causing movement.  In this case, contraction of the forearm muscles will lead to movement of the thumb and fingers

These tendons are secured and firmly attached to the bones of the thumb and fingers by running under what is called the tendon sheath.  This sheath is a band of connective tissue that is located over the tendons. The sheath is a very strong band of tissue that holds the tendons in proper positioning close to the bones of the wrist when the muscles are contracted.  As well as helping to firmly attach these tendons to the bones of the fingers and thumb, 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 called Trigger Finger and De Quervain’s Syndrome. Tenosynovitis wrist symptoms can significantly affect the function of the involved thumb or finger and can cause severe pain.

Some Tenosynovitis wrist symptoms that you may experience are:

• Stiffness the wrist and/or joints of the fingers and thumb
• Joint swelling and pain that increases with motion
• Feeling of locking or snapping when attempting to move the fingers and thumb, particularly with extension (straightening)
• Erythema, which is a reddening of the skin
• A low-grade fever might develop as the body’s attempt to fight infection
• Decreased function of the hand in general

Treatment for tenosynovitis of the wrist at Dr. Burke Orthopedics

The treatment for Tenosynovitis of the wrist will be a collaborative decision between you and Dr. Burke based on the location and severity of the condition.  Non-surgical intervention will most likely be successful in managing this condition. Optimally, Tenosynovitis wrist surgery will not be indicated.  Conservative Tenosynovitis of the wrist treatment 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 (trans cutaneous electrical stimulation) which interrupts pain signals are also interventions that you may be given in physical therapy.

When conservative measures fail to adequately reduce pain and improve function, surgical intervention may be necessary.  Tenosynovitis wrist 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.

For treatment options for bacterial synovitis, reach out to Dr. Burke Orthopedics today. New and current patients can choose their preferred appointment method between in clinic or Telemedicine Video clinic appointments. The arthritis relief you need is just a phone call or click away. Please make an appointment for a consultation with Dr. Burke by visiting the website or by calling (713) 436-3488.