Intersection Syndrome

By Johnny Barthel, OTR, CHT

What is Intersection Syndrome?

When one thinks of an intersection, one may correlate this with a place of crossing.  In the radial aspect (thumb side) of the distal forearm, there is a place of crossing as well.  In a distal forearm, there is a location where two muscle bellies groups cross or “intersect.”  These muscle bellies/tendons are in different sections in the forearm that are compartments.

image of Intersection Syndrome of hand

Intersection syndrome treatments are available at JOI


By being located on the back or the dorsal (posterior) aspect of the forearm these compartments are referred to as dorsal compartments.  These compartments contain the extensors of the digits and of the wrist. There are six dorsal extensor compartments.  Within these six compartments, two of them cross or “intersect.”  The two compartments that cross or “intersect” are known as the first dorsal extensor compartment (extensor pollicis brevis (EPB)/ abductor pollicis longus (APL)) and second dorsal extensor compartment (extensor carpi radialis longus (ECRL)/ extensor carpi radialis brevis (ECRB)).

At the location of intersection, an individual may experience inflammation or irritation.  These symptoms may result in a great deal of discomfort or pain.

What Causes Intersection Syndrome?

Intersection syndrome is from a direct trauma of the second extensor compartment. It is common of activities that require repetitive wrist extension and flexion. Rowers, weightlifters, and racquet sports are more prone to this condition.

Intersection Syndrome Defined

Intersection syndrome is the friction at the point where the muscle bellies of the EPB and the APL cross over the radial wrist extensors tendons proximal to the wrist joint approximately 4-5 cms., resulting in an inflammatory (swelling/irritation) peritendonitis.

This syndrome or condition may result from activities that involve a clenched fist with the thumb abducted.

The symptoms of intersection syndrome may include pain and swelling about the muscle bellies of the EBP and APL.  In some severe cases, redness and crepitus (a clicking or crackling sound often heard in movements) may be present.

Non-operative treatment may consist of the modification of activities and wrist splints.  Some patients may need an injection into the second dorsal extensor compartment.  Furthermore, for persistent pain, surgery may be the only option.

Therefore, if an individual encounters these signs and symptoms, he or she should not have to live with the discomfort.   The treatment that an individual receives should assist in allowing them to return to his or her everyday activities and hobbies.  The treatment should also assist an individual in enhancing his or her quality of life pain-free.

Wrist pain

Intersection Syndrome


You should stop or change activities that are causing your symptoms. Take frequent breaks when doing repetitive hand and thumb movements. Avoid repetitive motions such as wringing, turning, twisting, heavy grasping movements of the wrist. Anti-inflammatory medicines may help with pain and swelling. Ice treatments will also help with pain and swelling.

JOI Rehab

Whether you are suffering from wrist issues, joint pain, or injuries resulting from any type of activity, JOI has 12 physical therapy clinics conveniently located in Jacksonville and Northeast FL that specialize in orthopedic rehab.

If you are interested in scheduling an appointment at JOI Rehab for physical therapy, call (904) 858-7045. Come see us!

Related Articles: Bennett’s fracture break base your thumb and Hairline Fractures of the Arm. 


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Finally, to schedule for an acute injury or fracture, please call 904-JOI-2000 or click below.

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By: Johnny Barthel, OTR, CHT 

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