When you feel pain or a burning sensation in your ankle or wrist, the diagnosis will often be tenosynovitis. Pain usually occurs during movement and exertion; in chronic cases, however, the affected joint also hurts at rest. Tenosynovitis occurs primarily in the hand or wrist. But in the foot area, too, the tendons and tendon sheaths surrounding them can become inflamed. We will show you what happens in cases of tenosynovitis, what treatment is recommended, and how a splint or a wrist support can help.
What exactly is tenosynovitis?
The muscles and bones in the body are connected by tendons. Their task is to transfer muscle strength and to ensure mobility and stability. In some areas, tendons are enclosed by connective tissue, also known as tendon sheaths. They protect the tendons from abrasion and excessive strain, for example where a tendon runs across a bony protrusion. For this, the tendon sheaths contain a liquid. If they are subjected to excessive strain for an extended period, however, the tendon sheaths can become inflamed – and tenosynovitis is diagnosed.
Causes of tenosynovitis
If subjected to excessive strain, the tendon itself can become inflamed, but in the majority of cases, it’s the more sensitive tendon sheath that is affected. As the buffer between bones and tendon, it has to withstand a lot at times. If a repetitive movement is performed often and without breaks, the tendon sheath can become inflamed as a result of excessive strain.
In rare cases, an inflammation is caused by bacteria. Most of the time, however, it’s our everyday activities that cause tenosynovitis in the hand: playing the guitar, sports such as tennis, extended periods of typing on a keyboard, an ergonomically unfavorable design of the office work place, repetitive hand movements during assembly work – at work and leisure, there are numerous movements that subject the wrist to a lot of strain.
Tenosynovitis – typical symptoms and diagnosis
Tenosynovitis in the hand or wrist manifests initially as pain during gripping or movement. Swelling, reddening, and sensitivity to pressure aren’t uncommon either. In some cases, you may even be able to hear that something is wrong; the pain is then accompanied by rubbing or crunching sounds (tendovaginitis crepitans).
Depending on which tendon sheath has been affected and to what extent, there is a chance that the hand or individual fingers cannot be moved as usual. This may cause thickening in the tissue which limits mobility. This is the case with trigger finger (tendovaginitis stenosans) for example. The finger’s thickened flexor tendon gets stuck on a ligament and will only continue to move when increased force is exerted.
It’s crucial to consult a physician with this type of symptom – even if pain and problems only ever occur briefly. If left untreated, tenosynovitis can become chronic; in that case, the pain will remain even if you give the wrist a rest. Furthermore, treatment will then be prolonged.
To get a diagnosis, a description of the typical symptoms during your consultation with a physician and a physical examination will usually suffice. If the physician suspects there may be other causes of the problems, imaging technology, such as X-rays or ultrasound, can be used, or a blood test carried out to exclude bacterial infection.
In most cases, tenosynovitis can be treated conservatively, i.e. without surgery.
In order not to subject the inflamed tendon sheath to further irritation or strain, rest is the first recommendation. Since our hands are always in use, however, it makes sense to consciously immobilize the wrist. That’s why, in cases of tenosynovitis, your physician will initially prescribe you a splint, orthosis, support, or tape bandage. In this way, the inflamed tissue can recover and the swelling be reduced. Complete immobilization shouldn’t continue for too long though because the tendon and tendon sheath may otherwise stick together.
When the hand swelling is significant, anti-inflammatory medication, such as creams or tablets, but also cooling applications or electrotherapy can be used to promote the reduction of the swollen tissue.
Immobilization is usually followed by physiotherapy to train strength, coordination, and mobility of the hand, wrist, and forearm.
If conservative treatment is not effective contrary to expectations, surgical intervention remains the last resort. During this procedure, the surgeon will remove the thickened tissue that constricts the tendon sheath, and split the circular wrist ligament lengthways to restore unrestricted mobility to the tendons. In most cases, surgery can take place as outpatient treatment with a local anesthetic. This surgical procedure should only be used in cases of chronic tenosynovitis and as a last resort.
How does a wrist support help in cases of tenosynovitis?
In cases of tenosynovitis, immobilization and relief are the most important aspects of treatment. A wrist support, such as the ManuTrain, will help you to provide your wrist with the required rest without restricting your everyday activities.
The support consists of lightweight, breathable knitted fabric and a strap system that secures your wrist in a comfortable neutral position. This prevents strain on the tendon sheaths during flexing or bending of the wrist, resulting in the inflamed tissue being able to recover and heal more effectively.
At the same time, the support is comfortable to wear; it doesn’t constrict, thanks to the breathable material, unpleasant moisture doesn’t form, and you’re protected from getting too hot. You can put on and take off the support without effort to suit yourself, for example to take a break from the support during physiotherapy, when having a shower, or at night. Depending on the progression of the inflammation, you can wear the support subsequently in certain situations to prevent recurring irritation. In this way, the support will conveniently accompany you during everyday activities, helping you to become pain-free and stay that way.