Extensor tendonitis is a condition marked by irritation and inflammation of the tendons responsible for straightening the wrist, fingers, or toes. These tendons, which connect muscle to bone, become strained, leading to discomfort and limited mobility. The experience of this condition varies depending on which area of the body is affected.
Identifying the Location and Cause
Extensor tendons are situated along the back of the hand and forearm, and across the top of the foot. In the hand and wrist, these tendons allow you to lift your wrist backward and straighten your fingers. Tendonitis in this area is commonly triggered by repetitive strain or overuse, particularly through activities like prolonged typing, forceful gripping, or sports such as tennis.
In the foot, the extensor tendons run just beneath the skin on the top of the foot, enabling you to lift your toes and the front of your foot. Inflammation often stems from external mechanical factors, such as shoes that are too tight or shoelaces tied too constrictively over the arch. Sudden increases in high-impact activities, like running or extensive walking, can also place excessive stress on these tendons. The lack of protective muscle or fatty tissue over these tendons makes them susceptible to irritation from chronic friction or excessive tension.
Describing the Pain Sensation
The primary feeling associated with extensor tendonitis is a distinct pain localized directly over the inflamed tendon. This discomfort is often described initially as a dull ache that builds up with activity. In the acute phase, the pain can become sharper and more intense, sometimes accompanied by a burning sensation along the tendon’s length.
A prominent symptom is tenderness when the affected area is touched or pressed. Swelling or a palpable lump may be present along the tendon, which can sometimes be warm to the touch. Another specific sensation is crepitus, a crunchy or crackling feeling or sound that may occur as the tendon glides during movement.
If the condition progresses, the sharp pain may subside, giving way to a persistent, duller ache present even at rest. This chronic discomfort indicates a breakdown in the tendon tissue structure, known as tendinosis. In the wrist, this pain can sometimes radiate up into the forearm, creating a feeling of tightness or weakness during hand movements.
Triggers and Aggravating Factors
For the hand and wrist, pain sharply aggravates with specific movements that stretch or contract the affected tendon. These include extending the wrist backward (dorsiflexion) or attempting a forceful grip, such as turning a doorknob or lifting a heavy object. Repetitive, small movements like prolonged computer mouse use or typing can also cause a gradual escalation of pain and stiffness.
In the foot, the pain is most noticeable when the tendon is put on stretch, such as when the foot is flexed upward or during the push-off phase of walking or running. Pain is often worse in the morning or after any period of rest, a stiffness that usually eases slightly as the tendon warms up with gentle movement.
When Symptoms Require Professional Review
While many cases of extensor tendonitis respond well to rest and activity modification, certain symptoms necessitate a review by a healthcare provider. Self-care is likely insufficient if the pain is severe enough to interfere with sleep or normal daily activities. A medical professional should be consulted if the pain is worsening despite several days of rest and reduced activity.
Seek professional evaluation if you experience numbness or tingling in the fingers or toes, as this may suggest nerve involvement or a more complex underlying issue. Additionally, signs of potential infection, such as fever, spreading redness, or excessive warmth around the affected area, demand immediate medical attention. Early diagnosis can help confirm the condition and rule out other possible diagnoses, such as a stress fracture.