Wrist pain is a common issue often traced back to tendonitis, which is the inflammation of a tendon. Tendons are tough, flexible cords connecting muscle to bone. Because the wrist is involved in nearly every hand and arm movement, its tendons are particularly susceptible to irritation. Understanding wrist tendonitis and its management is the first step toward regaining comfortable movement.
Defining Wrist Tendonitis
Wrist tendonitis involves the inflammation of one or more of the tendons that bridge the forearm muscles to the bones in the hand. These structures are designed to glide smoothly, facilitating the complex movements of the hand, wrist, and fingers. The irritation can occur in flexor tendons on the palm side or extensor tendons on the back of the wrist.
A related condition, tenosynovitis, involves inflammation of the protective, fluid-filled sheath (synovium) surrounding the tendon, rather than the tendon itself. When irritated, this sheath restricts tendon movement, causing compression and pain, such as in De Quervain’s tenosynovitis near the thumb. The primary symptom is localized pain, which worsens when moving the wrist, gripping objects, or applying pressure. Swelling, warmth, and stiffness around the affected area are common. A distinct grinding or creaking sensation, known as crepitus, may also be felt when moving the joint.
Common Causes and Risk Factors
Wrist tendonitis usually develops from repetitive strain over time, rather than a single dramatic injury. The mechanism involves repeated micro-trauma to the tendon fibers, which leads to an inflammatory response as the body attempts to repair the damage. Activities requiring continuous, forceful, or awkward wrist movements are major contributors, such as heavy typing, using hand tools, or playing sports like golf and tennis.
Poor biomechanics, such as an incorrect wrist position while using a computer mouse or keyboard, can significantly increase the strain on specific tendons. Beyond mechanical stress, certain underlying systemic conditions can increase susceptibility to tendon inflammation. These include metabolic disorders like diabetes, as well as autoimmune conditions such as rheumatoid arthritis. Age can also be a factor, as natural changes in tendon tissue can reduce its ability to bear stress.
Initial Management at Home
Managing the initial flare-up of wrist tendonitis focuses on reducing inflammation and pain. The R.I.C.E. protocol provides a structured approach for immediate self-care:
- Rest requires avoiding activities that trigger pain, sometimes using a brace or splint to temporarily immobilize the joint.
- Ice should be applied to the painful area for 15 to 20 minutes several times a day to minimize swelling and numb the pain.
- Compression involves wrapping the wrist with an elastic bandage to reduce swelling, ensuring the wrap is snug without causing numbness or increased pain.
- Elevation means keeping the wrist raised above the level of the heart to encourage fluid drainage and reduce swelling.
Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can be used for short-term pain relief and to decrease inflammation. If pain is severe, if numbness or tingling develops, or if symptoms do not improve after seven to ten days of consistent home care, seek professional medical advice.
Professional Treatment and Recovery
When initial home management is insufficient, a healthcare provider introduces more formal medical treatments. Prescription-strength anti-inflammatory medications may be used to target persistent pain and swelling. Physical or occupational therapy is a common intervention, focusing on gentle stretching, strengthening exercises, and ergonomic adjustments to prevent recurrence.
A therapist may also recommend custom splinting to provide prolonged rest and optimal positioning for the irritated tendons. For cases that do not respond to conservative methods, a corticosteroid injection may be given directly into the tendon sheath to deliver anti-inflammatory medication. Surgery is reserved as a final option for chronic cases that have failed to improve after several months of non-surgical treatment. Recovery time is highly variable; mild cases resolve in a few weeks, while complex conditions may require a few months.