Yes, the hand and wrist are common sites for inflammation and irritation of the tendons, a condition generally known as tendonitis. A tendon is a tough, flexible cord of tissue that connects muscle to bone, transmitting the force necessary for movement. When these tendons or the surrounding protective sheaths become irritated, inflamed, or swollen, the resulting condition is tendonitis, which causes pain and impairs function. The frequent and complex movements performed by the hands and wrists make them particularly susceptible to this type of overuse injury.
Where Hand Tendonitis Develops
The complex anatomy of the hand and wrist contains numerous tendons, each moving through specialized tunnels called tendon sheaths, making several distinct areas vulnerable to inflammation. While “tendonitis” implies direct tendon inflammation, many hand and wrist issues are technically tenosynovitis, involving the inflammation of the tendon sheath. This inflammation often restricts the tendon’s smooth movement, which is frequently the source of pain and mechanical symptoms.
One of the most recognized forms is De Quervain’s Tenosynovitis, which affects the two thumb tendons (abductor pollicis longus and extensor pollicis brevis) on the thumb side of the wrist. These tendons are encased in a tight compartment, and inflammation causes pain, especially with grasping or gripping actions. Another common type is Trigger Finger or Thumb (Stenosing Tenosynovitis), involving the flexor tendons on the palm side of the fingers. Here, a nodule forms on the flexor tendon or the pulley system thickens, causing the finger to catch, lock, or snap when attempting to straighten it.
Tendons responsible for bending and straightening the wrist, known as the flexor and extensor carpi tendons, can also become inflamed. The extensor tendons run across the back of the hand, allowing the fingers to straighten, while the flexor tendons run along the palm side, enabling the fingers to bend. Inflammation can occur in any of these areas, causing localized tenderness and pain that may radiate into the forearm.
Activities and Conditions That Cause It
The primary cause of hand and wrist tendonitis is repetitive strain, resulting from performing the same motion repeatedly over time. This leads to microscopic tears and irritation in the tendon tissue. This category of injury, often called Repetitive Strain Injury (RSI), is common in occupations involving high-frequency movements, such as assembly line work or manual labor, or in specific hobbies like prolonged typing, gaming, or playing musical instruments.
Poor body mechanics and posture, or improper hand positioning while working, also contribute significantly to tendon inflammation. For example, using a keyboard or mouse with the wrist bent awkwardly increases friction on the tendons passing through the wrist tunnels. Acute trauma, such as a direct blow or sudden forceful movement, can also initiate the inflammatory process, though overuse is a more frequent culprit.
Certain systemic health conditions can increase susceptibility to tendonitis, even without excessive strain. Conditions like rheumatoid arthritis cause widespread inflammation that affects the tendon sheaths. Diabetes and thyroid disorders are also associated with a higher risk of developing hand tendonitis, particularly Trigger Finger and De Quervain’s Tenosynovitis. Hormonal changes and fluid retention, such as those experienced during pregnancy, can also predispose individuals to tenosynovitis.
Recognizing Symptoms and Treatment Options
Recognizing hand tendonitis typically involves identifying a few distinct symptoms, with the most common being pain and tenderness located directly along the affected tendon. This pain often intensifies during movement, especially when grasping, gripping, or forming a fist. Swelling, stiffness, and sometimes warmth or redness may also be visible over the inflamed area.
A unique symptom, particularly with Trigger Finger, is a catching, snapping, or locking sensation when the finger is flexed and then straightened. For De Quervain’s Tenosynovitis, the Finkelstein test is diagnostic: bending the thumb across the palm and then bending the wrist toward the little finger typically elicits sharp pain on the thumb side of the wrist. Diagnosis is generally confirmed through a physical examination and a review of the patient’s history, focusing on activities that aggravate the symptoms.
Initial treatment focuses on conservative methods aimed at reducing inflammation and promoting rest for the irritated tendon. The RICE protocol (Rest, Ice, Compression, and Elevation) is a primary self-care technique used to manage acute symptoms. Physicians often recommend splinting or bracing the wrist or finger to limit movement and allow the tendon time to heal.
Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can help manage pain and reduce swelling. A hand therapist may also develop a personalized plan incorporating gentle stretching and strengthening exercises to maintain range of motion and prevent stiffness. When conservative treatments are not successful, more advanced options are considered.
Corticosteroid injections deliver a powerful anti-inflammatory medication directly into the tendon sheath to decrease swelling and pain, often providing significant relief. These injections are effective, but they are not recommended for long-term or repeated use. If symptoms persist or the condition is severe, surgical intervention may be necessary. This involves procedures like releasing the thickened tendon sheath for Trigger Finger or decompressing the tendon compartment for De Quervain’s to allow the tendon to glide freely.