Generally, the episodes of wrist tendonitis have a multifactorial origin, ie they depend on several causes; these include: a certain anatomical predisposition of the wrist to inflammation of the tendons that cross it, the continuous repetition of some specific hand movements or fingers, the presence of a rheumatic disease, sudden functional overloads and the practice of very stressful jobs for the hands and their joints.
Wrist tendonitis mainly causes pain; the extent of the painful sensation is related to the severity of the inflammation: the more severe the inflammation, the more painful the wrist.
For a correct diagnosis of wrist tendonitis and for the precise identification of the triggering causes, a physical examination and anamnesis are often sufficient.
The first-line treatment is conservative and consists of: rest of the sore wrist from any activity that involves pain, application of ice several times a day, intake of anti-inflammatory drugs and use of a brace.
If first-line treatment is ineffective, surgery is required.
Wrist and Wrist Tendons: A Brief Review
The wrist is the even region of the human body, marking the end of the forearm and the beginning of the hand.
The protagonist bones of the skeletal structure of the wrist are the 8 carpal bones - the total set of which takes the anatomical name of carpus - and the radius with its distal end.
The wrist is home to an "important joint in the human body - the so-called wrist joint - on which the motor function of the hand depends.
Wrist Tendons
A tendon is a flexible band of fibrous connective tissue that joins a skeletal muscle to a bone.
At the wrist, the tendons of the extensor muscles and the flexor muscles of the fingers of the hand transit.
Enveloped by a particular synovial sheath, which protects them from rubbing and friction, the tendons passing through the wrist guarantee the insertion of the aforementioned muscles, originating in the forearm, in the bones of the hand (carpal bones, metacarpal bones and phalanges).
In the list below, some of the most important flexor and extensor muscles of the fingers of the hand are shown:
- Long flexor muscle of the thumb;
- The 4 deep flexor muscles of the fingers of the hand;
- The 4 superficial flexor muscles of the fingers of the hand;
- Long abductor muscle of the thumb;
- Extensor brevis muscle of the thumb.
Meaning of Tenosynovitis
In medicine, the term tenosynovitis indicates any inflammatory or irritative process affecting the synovial sheath, which surrounds the tendons of the human body.
), sudden functional overloads (eg: lifting excessive weights, lack of gradualness in the beginning of a sporting activity that involves the use of the wrist, etc.) and the continuous use, for work reasons, of vibrating tools.Wrist Tendonitis: Risk Factors
Doctors and experts agree that the risk factors for wrist tendonitis include:
- Practicing at high levels of sports such as baseball, bowling, golf and tennis;
- The practice of work activities involving the lifting of heavy weights or the continuous use of pneumatic hammers, electric saws, sewing machines, etc .;
- Prolonged use of the computer mouse and / or keyboard;
- Playing a musical instrument for many hours a day, which requires the use of the hands;
- The presence of rheumatoid arthritis;
- The state of pregnancy.
De Quervain Syndrome: a particular form of Wrist Tendinitis
When the inflammatory / irritative process affects the synovial sheath of the tendons belonging to the abductor longus muscles of the thumb and extensor short of the thumb, the resulting tenosynovitis is known, in the medical field, with the name of stenosing tenosynovitis of De Quervain or syndrome of De Quervain.
For more information on De Quervain syndrome, we recommend reading the dedicated article.
Meaning of "stenosing"
The word stenosing derives from the term stenosis, which, in the medical field, indicates any abnormal and unnatural narrowing of a blood vessel, a hollow or tubular organ, or an anatomical orifice.
Wrist Tendonitis: Epidemiology
Wrist tendonitis is a particularly widespread problem in the middle-aged female population and in those who practice work or sports, which are included in the risk factors.
.The extent of this pain varies according to the severity of the inflammation / irritation affecting the tendons and synovial sheaths: the more severe the inflammatory state, the greater the painful sensation felt.
Other Symptoms of Wrist Tendonitis
Sometimes, in addition to local pain, episodes of wrist tendonitis cause:
- Swelling around the wrist
- Emitting a creak or crepitus upon movement of the wrist joint;
- Stiffness in the wrist joint, especially in the morning immediately after waking up;
- Heat and redness at the level of where the inflamed / irritated tendons pass or transit on the wrist.
De Quervain's Stenosing Tenosynovitis: Symptoms
In De Quervain's syndrome, inflammation / irritation of the tendons passing through the wrist causes:
- Pain on the outside of the wrist and at the base of the thumb. To accentuate this pain are the grasping movements, performed with the thumb, and the inclination movements of the wrist;
- Swelling where the inflamed / irritated tendon resides;
- Formation of a protrusion on the wrist;
- Pain spread up to the forearm.
Importance of an Accurate Diagnosis of Causes
One of the main objectives of the diagnosis of wrist tendonitis is the identification of the triggering causes, as it is on the basis of these that doctors plan therapy.
In the diagnosis of the precise factors that cause wrist tendonitis, anamnesis plays a fundamental role, because it clarifies the patient's work activity, his sporting hobbies, his general state of health, etc.
If this treatment fails or does not provide the desired results, there are grounds for resorting to physiotherapy and, in extreme cases, even surgery.
Wrist Tendonitis: Conservative Remedies
Ice: how and for how long to apply it?
The use of ice has a remarkable anti-inflammatory power, which many people underestimate.
Normally, in the presence of conditions such as wrist tendonitis, doctors recommend applying ice 4-5 times a day, for a period of time between 15 and 20 minutes (less and more, the remedy is little. effective).
Wrist brace: why and how to use it
The use of the brace protects the wrist from excessive movements, which could cause pain.
Doctors recommend the wrist brace especially to those who carry out a "manual work activity and who cannot stop it, despite the presence of" inflammation of the tendons.
Anti-inflammatory drugs: what are they for?
Generally, for patients with wrist tendonitis, doctors prescribe NSAIDs as a first-line drug treatment and reserve the right to resort to corticosteroids only if the aforementioned NSAIDs prove ineffective. In fact, it is necessary to remember that corticosteroids pay for their high anti-inflammatory power with various drawbacks connected to their prolonged or inappropriate use (eg: glaucoma, hypertension, obesity, etc.).
Wrist Tendonitis: Physiotherapy
Physiotherapy for wrist tendonitis includes:
- Exercises of stretching, mobility and strengthening of the muscles involved in the movements of the wrist and hand;
- Instrumental therapies, such as tecar therapy, shock waves, laser therapy, ultrasound and / or magnetotherapy.
Numerous studies have shown that stretching, mobility and strengthening of the muscles responsible for wrist and hand movements have an "important therapeutic power.
Wrist Tendonitis: Surgical Therapy
Surgery is reserved for cases of wrist tendonitis that do not respond positively to conservative therapies.
Surgery for wrist tendonitis involves repairing the tendon (s) which, due to inflammation, have a lesion in the structure.
Normally, after surgery for wrist tendonitis, a period of physiotherapeutic treatment is foreseen to restore the mobility of the joint.
