Generality
Wrist tendonitis is the inflammatory process, sometimes of a degenerative nature, which has as its object the tendons passing through the wrist and / or their synovial sheaths.
Wrist tendonitis mainly causes pain; the extent of the pain sensation is related to the severity of the inflammation: the more severe the latter, the more painful is the pulse.
For a correct diagnosis of tendonitis on the wrist and for the precise identification of the triggering causes, physical examination and anamnesis are often sufficient.
The first-line treatment is conservative and consists of: resting the painful wrist from any activity that involves pain, applying ice several times a day, taking anti-inflammatory drugs and using a guardian.
If the first-line treatment is ineffective, surgery is needed.
Brief anatomical revision of the wrist and its tendons
The wrist is the even region of the human body, which marks the end of the forearm and the beginning of the hand .
The bones of the skeletal structure of the wrist are the 8 carpal bones - whose total set takes the anatomical name of carpus - and the radium with its distal end.
The wrist is the seat of an important articulation of the human body - the so-called wrist joint - on which the motor function of the hand depends.
WRIST TENDONS
A tendon is a band of fibrous connective tissue, with a certain flexibility, which combines a skeletal muscle with a bone.
At the wrist level, the tendons of the extensor muscles and the flexor muscles of the fingers pass.
Wrapped in a particular synovial sheath, which preserves them from rubbing and friction, the tendons passing through the wrist guarantee the insertion of the aforementioned muscles, with origin 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 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;
- Short extensor muscle of the thumb.
What is a wrist tendonitis?
Wrist tendonitis - also known as wrist tendinopathy or wrist tenosynovitis - is an inflammatory condition, sometimes of a degenerative / irritative nature, which has as its object one or more tendons passing through the wrist and the synovial sheaths that surround them.
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.
Causes
Generally, episodes of tendonitis on the wrist have a multifactorial origin, that is, they arise due to more concomitant causal factors.
Among the possible causes of a tendinitis on the wrist, they certainly deserve a quotation: a certain anatomical predisposition to the problem, the continuous repetition of some specific movements of the hand or fingers, the presence of a rheumatic disease (eg: rheumatoid arthritis), overloads sudden functional (eg: lifting of excessive weights, non-gradualness in the beginning of a sporting activity which involves the use of the wrist, etc.) and the continuous use, for work reasons, of vibrating instruments.
Risk factors
Doctors and experts agree that the risk factors for wrist tendonitis include:
- The practice at high levels of sports such as baseball, bowling, golf and tennis;
- The practice of working activities in which the lifting of considerable weights or the continuous use of pneumatic hammers, electric saws, sewing machines, etc is expected;
- Prolonged use of the mouse and / or computer keyboard;
- Play a musical instrument many hours a day, which requires the use of hands;
- The presence of rheumatoid arthritis;
- The state of pregnancy.
A particular wrist tendonitis: De Quervain syndrome
When the inflammatory / irritative process affects the synovial sheath of the tendons belonging to the long abductor muscles of the thumb and short extensor of the thumb, the resulting tenosynovitis is known, in the medical field, with the name of stenosing tenosynovitis by De Quervain or De syndrome Quervain . For more information, read the dedicated article
Meaning of "stenosante"
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.
Epidemiology
Wrist tendonitis is a particularly widespread problem in the middle-aged female population and in those who practice jobs or sports, falling within the risk factors.
Symptoms and complications
The typical symptom of wrist tendonitis is wrist pain .
The extent of this pain varies according to the severity of the inflammation / irritation of the tendons and synovial sheaths: the more the inflammatory state is severe, the greater the painful sensation felt.
Other symptoms
Sometimes, in addition to local pain, episodes of tendonitis in the wrist cause:
- Swelling around the wrist;
- Cracking or crackling sound on the 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, in the wrist, the inflamed / irritated tendons pass or pass.
Symptoms of stenosing tenosynovitis by De Quervain
In De Quervain syndrome, inflammation / irritation of tendons passing through the wrist determines:
- Pain on the outer face of the wrist and at the base of the thumb. To accentuate this pain are the gripping 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;
- Diffuse pain up to the forearm.
Diagnosis
In most cases, doctors diagnose tendonitis on the wrist and identify the triggers only thanks to a thorough physical examination and a thorough medical history .
Very rarely, they add more in-depth tests, such as ultrasound, to the above-mentioned diagnostic tests.
Importance of an accurate diagnosis of the causes
One of the main objectives of the diagnosis of wrist tendonitis is the identification of the triggering causes, as it is based on the latter that the doctors plan the therapy.
In discovering the precise factors that cause wrist tendonitis, the medical history plays a fundamental role, because it clarifies the patient's working activity, his sports hobbies, his general state of health and so on.
Therapy
The first-line treatment of a tendinitis on the wrist is conservative and involves: observation of a rest period from all the activities that favor the appearance of pain, the application of ice on the swollen area and on the site of pain, using a wrist brace and taking anti-inflammatory drugs with pain-relieving effects .
If this treatment fails or does not provide the expected results, the bases for the use of surgery and physiotherapy exist.
Mode of application of ice
The use of ice has a remarkable anti-inflammatory power, which many people underestimate.
As a rule, under conditions such as tendonitis on the wrist, doctors recommend applying ice 4-5 times a day for at least 15-20 minutes.
Use of wrist brace
The use of the brace protects the wrist from excessive movements, which could cause pain.
Doctors advise the wrist brace especially to those who carry out manual work and who cannot interrupt it, despite the presence of inflammation on the tendons.
Anti-inflammatory drugs
In general, for patients with tendonitis on the wrist, doctors prescribe NSAIDs as a first-line drug treatment and reserve the right to use corticosteroids only if the aforementioned NSAIDs prove ineffective. In fact, it must be remembered that corticosteroids pay their high anti-inflammatory power with various drawbacks linked to their prolonged or inappropriate use (eg: glaucoma, hypertension, obesity, etc.).
Prognosis
The prognosis of a wrist tendonitis depends on when the diagnosis and treatment take place: if the diagnosis and treatment are early, the chances of recovery are high; on the contrary, if the diagnosis and treatment are late, achieving recovery is much more difficult and the risk of inflammation becoming chronic is much more concrete.
Prevention
Do not overdo sports activities at risk, avoid the continuous repetition of wrong movements with the wrist, observe breaks during work activities or hobbies that require the continuous use of hands, wear special braces (clearly when possible or allowed) and, finally, performing wrist stretching exercises if you are in the risk categories, are the main preventive measures against wrist tendonitis.
How to avoid the aggravation of a tendonitis on the wrist
Refrain from activities that involve pain and avoid taking painkillers without first consulting a doctor (as these eliminate pain, but do not solve the problem) are the main tips given by doctors to prevent the aggravation of a tendinitis On the wrist.
