Wrist tendonitis is a common condition where one or more tendons within the wrist become inflamed. This occurs when the tough, fibrous cords connecting muscles to bones become irritated. Tendonitis specifically involves these connective tissues, and often impacts daily activities.
Understanding Wrist Tendonitis
Tendons are strong, rope-like structures that transmit force from muscles to bones, enabling joint movement. In the wrist, tendons from forearm muscles extend into the hand and fingers, facilitating motion. These tendons are encased in a protective sheath lined with synovial fluid for smooth gliding. Inflammation of a tendon or its sheath disrupts this movement, causing the sheath to thicken, swell, and compress the tendon, leading to pain.
Wrist tendonitis can manifest in different forms, depending on the specific tendons affected. De Quervain’s tenosynovitis, a common type, involves tendons on the thumb side of the wrist, causing pain when grasping objects or moving the thumb. Extensor carpi ulnaris (ECU) tendonitis affects tendons on the pinkie finger side, causing pain when straightening the wrist or bending it towards the little finger.
Common Causes and Symptoms
Wrist tendonitis often develops from repetitive stress on wrist tendons. Frequent motions like typing, using a computer mouse, texting, or sports such as tennis or golf are common causes. Occupations requiring repetitive hand and wrist movements, like those involving heavy machinery or manual labor, also contribute. A sudden injury, such as falling on an outstretched hand, can directly lead to tendon inflammation. Certain medical conditions, including rheumatoid arthritis, diabetes, or poorly aligned joints, may increase susceptibility.
Individuals with wrist tendonitis experience pain, ranging from a dull ache to a sharp, burning sensation. This pain worsens with wrist, hand, or finger movement and may radiate into the forearm. Tenderness to the touch and swelling are common over the affected area. Some report a grating, clicking, or creaking sensation when moving the wrist, known as crepitus. Weakness in grip strength or reduced range of motion are also symptoms.
Diagnosis and Treatment Approaches
Diagnosing wrist tendonitis typically begins with a physical examination by a healthcare professional. The doctor assesses the wrist for tenderness, swelling, and warmth. They also evaluate the wrist’s range of motion and observe how certain movements affect the pain. For instance, the Finkelstein test, which involves bending the wrist towards the little finger while the thumb is tucked into the palm, can help diagnose De Quervain’s tenosynovitis if it causes pain. A medical history, including daily activities and any previous injuries, is also gathered. Imaging tests, such as X-rays, may be performed to rule out other conditions like fractures, while an MRI can provide more detailed views of soft tissues like tendons.
Treatment for wrist tendonitis often begins with conservative, non-surgical methods aimed at reducing inflammation and pain. Rest is a primary recommendation, involving avoidance of activities that aggravate the wrist. Applying ice packs to the affected area helps minimize swelling and pain. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) can also alleviate discomfort. Splinting or bracing the wrist provides support and immobilizes the tendons, promoting healing.
Physical therapy plays a significant role in recovery, guiding patients through exercises and stretches to improve strength, flexibility, and range of motion. Manual therapy, involving hands-on techniques, may also improve wrist movement. Corticosteroid injections directly into the tendon sheath can reduce inflammation. If conservative treatments do not yield sufficient improvement after several months, surgery may be considered. Surgical procedures typically involve cleaning damaged tissue and making small incisions in the tendon sheath to release pressure and allow for smoother tendon movement.
Preventing Wrist Tendonitis
Preventing wrist tendonitis involves reducing tendon strain, especially during repetitive tasks. Proper ergonomics, particularly for computer users, is important. This includes maintaining a neutral wrist position, aligning the wrist straight with the forearm. Taking regular breaks during repetitive activities allows tendons to rest and recover, preventing overuse.
Stretching exercises for the wrist and forearm help maintain flexibility and reduce stiffness. Strengthening exercises for wrist muscles enhance their ability to withstand stress. Using proper form during sports or physical activities minimizes strain on wrist tendons. When lifting objects, using both hands distributes the load and reduces stress on individual tendons.