A tendon is a fibrous cord-like structure that attaches a muscle to bone. There are several tendons surrounding and crossing through the wrist joint responsible for creating the movements of the wrist, hand, and fingers we rely on every day to perform basic activities of daily living to throwing 100+ MPH fast balls in elite-level athletes.
Normal functioning tendons slide within a sheath lined with synovial fluid to provide smooth and frictionless movement. Injury to the tendon or tendon sheath can occur with repetitive activities such as gripping, pinching, throwing, and prolonged computer use. Injured tendons become inflamed causing the lining of the sheath or sheath itself to thicken, preventing the tendon from freely gliding. Inflammation of a tendon or tendon sheath is known as tendinitis and tenosynovitis respectively. Once a tendon becomes inflamed, normal movements of the wrist become painful and leads to decreased range of motion and strength impacting the individual’s ability to perform self-care, homemaking, and recreational activities. A sprain wrist is when the ligaments are injured or stretched out. The symptoms may often appear to be similar to wrist tendonitis.
A common form of wrist tendinitis is known as Dequervain tenosynovitis, an inflammation of the tendons and/or tendon sheath at the base of the back of the thumb and wrist that causes pain with grasping, pinching, or twisting. Individuals with jobs or hobbies that involve repetitive motions of the wrist and hand are more susceptible to Dequervain’s, in addition to new mothers from continuous lifting of the baby. Dequervain’s can be diagnosed by performing the Finkelstein test, where the patient bends their thumb while wrapping all the other fingers around it and bending the wrist towards the little finger. Pain at the base of the thumb and wrist indicates a positive test for Dequervain's.
Wrist pain can be attributed to several factors and determining the source of pain is key to providing appropriate treatment. Wrist pain should be properly diagnosed by first seeing an upper extremity orthopedic physician for further evaluation. Depending on the severity of wrist pain, treatments can range from conservative methods to requiring surgical intervention. Common forms of treatment for wrist tendinitis:
· Immobilization using an orthosis to limit movements of the wrist and thumb to allow irritated and inflamed tendons to become calm.
· Corticosteroid injections and use of non-steroidal anti-inflammatory drugs. If indicated, the upper extremity physician can inject a concentrated amount of corticosteroid directly into the joint to decrease both inflammation and pain. Dr. Garry Kitay states "wrist tendonitis can cause excruciating pain at times. If it does not resolve quickly with rest and splinting, steroid injections tend to be very effective." Dr. Kitay is board certified by the American Board of Orthopaedic Surgery and practices at JOI San Marco.
· Activity modification and patient education.
· Surgical intervention to increase the space where the tendons travel to allow increased “breathing” room for inflamed tendons and/or tendon sheath.
-Physical Therapy can be very important in the recovery process if you have tondinitis of the wrist or you have had surgery for this condition. JOI Rehab has 11 locations in Northeast Florida to get you back on the road to recovery.
If you think you have a sprain of your ligaments in the wrist or wrist tendinitis, JOI can help. Call 904 858-7045