The hand is one of the most common sites for tendonitis, or tendinopathy, which involves the irritation or inflammation of a tendon—the fibrous cord connecting muscle to bone. The hands and wrists are complex, containing numerous tendons responsible for fine motor skills and gripping movements. Because these structures are subjected to frequent, repetitive motions and high mechanical stress, the tendons and their protective sheaths are often prone to irritation and painful conditions.
Specific Forms of Hand and Wrist Tendinopathy
The intricate anatomy of the hand and wrist means tendon irritation manifests in several distinct conditions.
De Quervain’s Tenosynovitis
One of the most frequently diagnosed conditions is De Quervain’s Tenosynovitis, which affects the two tendons responsible for moving the thumb away from the hand. These tendons run through a narrow sheath on the thumb side of the wrist. When the sheath becomes thickened and inflamed, the gliding motion of the tendons is restricted, causing pain.
Trigger Finger
Medically termed stenosing tenosynovitis, this involves the flexor tendons on the palm side of the hand. It results from inflammation and thickening of the tendon sheath at the A1 pulley near the base of the finger or thumb. The tendon struggles to pass smoothly through the constricted pulley, leading to a noticeable catching, popping, or locking sensation when bending or straightening the digit.
Beyond these specific conditions, generalized extensor or flexor tendonitis can affect any of the dozens of tendons in the hand and wrist. Extensor tendons run along the back of the hand, allowing fingers and the wrist to straighten. Flexor tendons are located on the palm side and facilitate bending and gripping.
Recognizing the Signs and Contributing Factors
A person experiencing tendon irritation in the hand typically notices a collection of physical signs. The most consistent symptom is localized pain and tenderness, which often worsens significantly with specific movements. This discomfort may present as a dull ache at rest but becomes a sharp sensation during activity. Swelling and warmth over the irritated tendon are also common. Some individuals may experience stiffness, particularly when waking, or a reduced range of motion. An audible or palpable grating sensation, known as crepitus, can sometimes be felt as the irritated tendon attempts to glide through its constricted sheath.
The conditions are largely driven by specific contributing factors that increase mechanical stress on the tendons. Repetitive motions are the primary cause, often seen in occupations or hobbies that require frequent grasping, pinching, or wringing actions (e.g., typing, knitting, or certain sports). Poor hand and wrist positioning, or ergonomics, during these sustained activities can exacerbate the strain. A sudden increase in activity level without proper conditioning can overload the tendons and trigger the irritation. Underlying health conditions, such as diabetes and inflammatory arthritis, can also predispose someone to these issues.
Immediate Steps and Medical Consultation
For a person who suspects they have hand or wrist tendon irritation, the initial steps should focus on reducing the mechanical load and inflammation. The most immediate self-care strategy is applying the RICE principle, beginning with Rest and activity modification to avoid movements that provoke the pain. Applying Ice to the localized area for 10 to 15 minutes several times a day can help reduce swelling and discomfort. Using a soft brace or splint for Compression and support can help immobilize the affected joint, which is particularly helpful for conditions like De Quervain’s Tenosynovitis. Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may also be used to help manage pain and reduce localized inflammation.
While many mild cases improve with these self-care measures, medical consultation is warranted if the pain persists or worsens after a few days of rest and modification. Professional help is also needed if there is a noticeable loss of function, significant swelling, or if the pain is severe enough to interfere with basic daily tasks. A medical provider can offer a precise diagnosis and may recommend physical therapy to improve strength and flexibility. Further clinical treatments could include prescription-strength anti-inflammatory medication or a corticosteroid injection directly into the tendon sheath to reduce inflammation. Surgery is typically reserved as a last resort for chronic cases that do not respond to conservative management, often involving the release of the tight tendon sheath to allow for smooth tendon gliding.