The wrist joint, which connects the hand to the forearm, plays an important role in the overall function of the hand and arm. Damage to the wrist can severely impact an individual’s ability to perform daily tasks.
Like any joint, the wrist relies on tendons—strong cords of tissue made of collagen—in order to function correctly. When the tendons are healthy, they enable the bones to move smoothly within the wrist. However, when subjected to repetitive motion, stress, or strain, the tendons may become inflamed. The result is wrist pain (sometimes sharp, shooting pain), decreased grip strength, stiffness, tenderness, numbness, swelling, warmth, redness, reduced range of motion, and what many patients describe as a “grating feeling.” Although any one of the six tendons may become inflamed, tendonitis of the wrist usually occurs near the wrist bone, where the tendons cross each other.
The lining of the tendon sheath around the base of the thumb can also become inflamed, resulting in swelling, pain, and stiffness. This is not wrist tendonitis but a related condition called De Quervain’s tenosynovitis. A single patient may suffer from both wrist tendonitis and De Quervain’s tenosynovitis, meaning that the sheath and the tendon itself are both inflamed at the same time.
The cause of wrist tendonitis can be difficult to pinpoint, but it is most often related to wrist strain, overuse, repetitive motion, or infection. It may also occur as the result of diabetes or rheumatoid arthritis.
Those most susceptible to wrist tendonitis are:
Tendonitis can also be caused by sudden trauma to the wrist, for example, as the result of an accident or fall.
Treatment for wrist tendonitis depends on the severity of the symptoms and the location of the tendonitis in the wrist joint. Generally, a physician will examine the wrist, test its flexibility and strength, and order imaging of the joint to determine the exact location of the wrist tendonitis.
Treatment strategies tend to progress in stages, and begin with the least invasive measures. The focus is on finding a treatment that successfully alleviates the symptoms. The stages include:
Step 1--Decrease inflammation and pain through the use of anti-inflammatory non-steroidal medications, the application of heat and ice, resting the affected area, restricting movement of the wrist, and/or physical therapy.
Step 2--If the measures taken in step one fail to reduce swelling and pain, inject steroids into the affected areas.
Step 3--When steps one and two fail to alleviate wrist tendonitis, reduce or eliminate the swelling and pain with surgery.
When wrist tendonitis continues to be painful and debilitating despite the use of more conservative non-operative treatments, surgery may be necessary. Surgery will remove damaged tissue, increase blood flow to the damaged tendon, and stimulate the influx of blood cells to aid healing.
During the procedure, the surgeon makes an small incision near the affected tendon. With the aid of a surgical loupe (special glasses with microscopic vision), tiny surgical tools are used to repair the tendons or remove scar tissue. The use of arthroscopy This procedure limits scar tissue and damage to the surrounding tissue. It also significantly speeds up the healing process.
After surgery, the wrist will be immobilized to aid the healing process. Generally, the wrist is placed in a splint for about a week or a brace for approximately three to four weeks. The progress of the healing process will be monitored, usually through the use of an imaging device. Wrist tendons typically take about six weeks to heal completely. Tendonitis rarely reoccurs after surgery. However, it is very important to follow all of the post-operative instructions to minimize complications.
“De Quervain’s tenosynovitis,” Mayo Clinic Patient Care & Health Information , https://www.mayoclinic.org/diseases-conditions/de-quervains-tenosynovitis/symptoms-causes/syc-20371332
“Surgery for Wrist Tendonitis,” Sports-Health, https://www.sports-health.com/sports-injuries/hand-and-wrist-injuries/surgery-wrist-tendonitis
“Wrist Tendonitis,” Surgery Center of Allentown, https://scoallentown.com/hand-conditions/wrist-tendonitis/
“Wrist Tendonitis Surgery,” Tri-County Orthopedics, https://www.tri-countyortho.com/patient-resources/education/wrist-tendonitissurgery#:~:text=During%20a%20wrist%20tendonitis%20surgery,will%20make%20sutures%20as%20needed.