Wrist Tendonitis: Causes, Symptoms, and Treatment

What is Wrist Tendonitis?

Wrist tendonitis, also known as tenosynovitis, is a condition that causes inflammation and irritation of the tendons in the wrist. Tendons are strong, fibrous cords that connect muscles to bones. They allow the wrist to bend, twist, and move in different directions.

Wrist tendonitis can affect one or more tendons in the wrist, depending on the location and cause of the inflammation. The most common tendons affected are:

• The extensor carpi radialis brevis (ECRB) and extensor carpi radialis longus (ECRL), which run along the back of the forearm and help extend the wrist and fingers.
• The extensor pollicis brevis (EPB) and abductor pollicis longus (APL), which run along the thumb side of the wrist and help move the thumb away from the palm.
• The flexor carpi radialis (FCR) and flexor carpi ulnaris (FCU), which run along the front of the forearm and help flex the wrist and fingers.

Types of Wrist Tendonitis

There are several types of wrist tendonitis, each affecting different tendons and causing different symptoms. Some of the most common types are:

De Quervain's Tenosynovitis

De Quervain's tenosynovitis is a type of wrist tendonitis that affects the tendons on the thumb side of the wrist. These tendons are the extensor pollicis brevis (EPB) and the abductor pollicis longus (APL), which help move the thumb away from the palm.

De Quervain's tenosynovitis is caused by inflammation of the tendon sheath, which is a thin layer of tissue that surrounds and lubricates the tendons. The inflammation can make the sheath swell and compress the tendons, causing pain and difficulty moving the thumb.

De Quervain's tenosynovitis can be triggered by overuse or repetitive stress on the thumb and wrist, such as texting, playing video games, or lifting heavy objects. It can also be associated with pregnancy, rheumatoid arthritis, or diabetes.

The symptoms of De Quervain's tenosynovitis include:

• Pain and tenderness on the thumb side of the wrist, especially when moving or applying pressure to the thumb.
• Swelling and redness on the thumb side of the wrist.
• Difficulty gripping or pinching objects with the thumb and index finger.
• A snapping or clicking sensation when moving the thumb.

Ulnar Tendonitis

Ulnar tendonitis is a type of wrist tendonitis that affects the tendons on the pinky side of the wrist. These tendons are the flexor carpi ulnaris (FCU) and the extensor carpi ulnaris (ECU), which help flex and extend the wrist and fingers.

Ulnar tendonitis is caused by inflammation or irritation of the tendons due to overuse or injury. It can also be related to underlying conditions such as gout, psoriatic arthritis, or ulnar nerve entrapment.

The symptoms of ulnar tendonitis include:

• Pain and tenderness on the pinky side of the wrist, especially when bending or twisting the wrist.
• Swelling and warmth on the pinky side of the wrist.
• Reduced range of motion and function of the wrist and fingers.
• Numbness or tingling in the pinky finger or ring finger.

Extensor Carpi Radialis Tendonitis

Extensor carpi radialis tendonitis is a type of wrist tendonitis that affects the tendons on the back of the forearm that help extend the wrist and fingers. These tendons are the extensor carpi radialis brevis (ECRB) and the extensor carpi radialis longus (ECRL).

Extensor carpi radialis tendonitis is caused by inflammation or degeneration of the tendons due to overuse or injury. It can also be associated with conditions such as rheumatoid arthritis, osteoarthritis, or lateral epicondylitis (tennis elbow).

The symptoms of extensor carpi radialis tendonitis include:

• Pain and tenderness on the back of the forearm near the elbow, especially when extending the wrist or fingers.
• Swelling and stiffness on the back of the forearm near the elbow.
• Difficulty performing tasks that require wrist extension, such as typing, writing, or playing racquet sports.

These are some of the most common types of wrist tendonitis, but there may be others that affect different tendons or have different causes.

What Causes Tendonitis In The Wrist

There are several factors that can cause or contribute to wrist tendonitis, such as:

• Overuse or repetitive stress on the wrist: This is the most common cause of wrist tendonitis. Activities that involve frequent or prolonged wrist motions, such as typing, texting, playing video games, writing, or using a computer mouse, can put excessive strain on the tendons and cause them to become inflamed. This is also known as a repetitive strain injury or RSI.
• Injury or trauma to the wrist: This can include a sprain, fracture, dislocation, or puncture wound that damages the tendons or the surrounding tissues. Injury can also cause bleeding or swelling in the tendon sheath, which is a thin layer of tissue that surrounds and lubricates the tendons. This can make the sheath thicken and compress the tendons, causing pain and difficulty moving the wrist.
• Inflammation or infection of the tendon sheath: This can occur due to an autoimmune disease, such as rheumatoid arthritis or psoriatic arthritis, that causes the immune system to attack healthy tissues in the joints and skin. It can also occur due to a bacterial infection that enters the tendon sheath through a cut or wound. This can cause redness, warmth, and pus in the wrist.
• Underlying medical conditions: Some health conditions can affect the metabolism or circulation of the tendons, making them more prone to inflammation or degeneration. These include diabetes, gout, thyroid disorders, kidney disease, and osteoarthritis.

Some people may be more likely to develop wrist tendonitis than others due to certain risk factors, such as:

• Age: Wrist tendonitis is more common in older adults, as the tendons tend to lose elasticity and strength over time.
• Gender: Wrist tendonitis is more common in women than men, possibly due to hormonal changes or differences in anatomy.
• Genetics: Wrist tendonitis may run in families, as some people may inherit a tendency to have weaker or more sensitive tendons.
• Lifestyle: Wrist tendonitis may be influenced by habits such as smoking, drinking alcohol, eating a high-purine diet, or having poor posture.

Wrist tendonitis is a common condition that can affect anyone who uses their wrists frequently or suffers an injury. By understanding wrist tendonitis causes and risk factors, you can take steps to prevent it from happening or manage it effectively if it does.

Wrist Tendonitis Symptoms

Typical wrist tendonitis symptoms are:

• Wrist pain: This is the most common symptom of wrist tendonitis. The pain may vary depending on the type and severity of tendonitis, but it usually worsens with movement or activity. The pain may be dull, sharp, throbbing, or burning. It may also radiate to the hand or forearm.
• Wrist swelling: The inflammation in the wrist joint can cause fluid accumulation and swelling around the joint. The swelling may be visible or palpable, and it may make the wrist feel tight or warm.
• Wrist stiffness: The loss of elasticity and strength in the tendons can limit the range of motion and flexibility of the wrist. The stiffness may be worse in the morning or after periods of rest, and it may improve with gentle movement or warm compresses.
• Wrist weakness: The pain and stiffness in the wrist joint can affect the strength and function of the wrist and hand muscles. This can make it difficult to grip, lift, or hold objects. It can also affect fine motor skills, such as buttoning, zipping, or writing.
• Wrist crepitus: The inflamed tendon may make a creaking or grinding noise when moving the wrist. This is due to friction between the tendon and its sheath.

Diagnosis and Medical Evaluation

To diagnose wrist tendonitis, a doctor will do a physical examination and take a medical history. The doctor may also order some imaging tests to rule out other possible causes of the symptoms.

Physical Examination and Medical History

The physical examination and medical history are the first steps in diagnosing wrist tendinitis. The doctor may ask the patient about:

• The onset, duration, and severity of pain and other symptoms
• Any previous or recent injuries or trauma to the wrist
• Any activities or occupations that involve repetitive or prolonged wrist motions
• Any underlying medical conditions that may affect tendons, such as rheumatoid arthritis, gout, diabetes, or thyroid disorders
• Any medications or supplements you are taking

Your doctor will also check your wrist for:

• Tenderness on palpating (gently applying pressure) the wrist, hand, and forearm
• Flexibility and range of motion of the wrist and forearm
• Swelling and/or bruising in the wrist, hand, and/or forearm
• Crepitus (cracking or grinding sensation) in the wrist

Imaging Tests

Imaging tests are used to confirm the diagnosis of wrist tendonitis and to rule out other conditions that could be causing the symptoms. Wrist tendonitis diagnosis tests include:

• X-rays: X-rays can show any fractures or dislocations of the bones in the wrist. They can also show any changes in the shape or alignment of the bones due to arthritis or other degenerative diseases.
• Ultrasound: Ultrasound can show any inflammation, swelling, or tears of the tendons in the wrist. It can also show any fluid accumulation or infection in the tendon sheath.
• MRI: MRI can provide a detailed image of the soft tissues in the wrist, such as the tendons, ligaments, muscles, nerves, and blood vessels. It can show any damage or degeneration of the tendons or their sheath.

Based on the results of these tests, the doctor can determine the type and severity of wrist tendonitis and prescribe the appropriate treatment.

Wrist Tendonitis Treatment

The treatment for wrist tendonitis depends on the severity and cause of the condition, but it may include:

Non-surgical Treatment

Non-surgical treatment is usually the first option for wrist tendonitis. It aims to reduce pain and inflammation, prevent further damage to the tendons, and improve mobility and function of the wrist. Non-surgical treatment of tendonitis in wrist include:

• Resting and immobilizing the wrist with a splint or brace: Wrist braces for tendonitis can help protect and stabilize the wrist joint, reduce stress on the tendons, and limit movement that may cause pain. The splint or brace should be worn for several weeks or until symptoms improve.



Zofore Sport Wrist Brace with Metal Splint Stabilizer

• Applying ice or heat packs to the wrist: This can help reduce pain and swelling in the wrist joint. Ice packs can be applied for 15 to 20 minutes several times a day, especially after activity. Heat packs can be applied for 15 to 20 minutes once or twice a day, especially before activity.
• Taking anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen: These can help relieve pain and inflammation in the wrist joint. They should be taken as directed by your doctor or pharmacist, and only for a short period of time. NSAIDs may have side effects such as stomach irritation, bleeding, or kidney problems.
• Receiving corticosteroid injections: These can help reduce severe pain and inflammation in the wrist joint. They are injected directly into the affected tendon or its sheath by your doctor. Corticosteroid injections may provide temporary relief for several weeks or months, but they should not be used too often or too long as they may weaken the tendons or cause other complications.
• Doing hand therapy exercises: These can help improve strength and flexibility of the wrist joint. They can also teach you how to protect your tendons from further injury. Hand therapy exercises may include stretching, strengthening, range of motion, massage, ultrasound, electrical stimulation, or other modalities. You should consult your doctor or physical therapist before starting any exercise program and follow their instructions carefully.

Surgical Treatment

Surgical treatment may be considered when non-surgical treatments fail to provide adequate relief or when there is significant damage or deformity of the tendons. The type of surgery depends on the location and extent of wrist tendonitis, but it may include:

• Joint debridement: This involves removing loose fragments of cartilage or bone from within the joint to improve movement and reduce pain.
• Tendon release: This involves cutting a small portion of the tendon sheath to relieve pressure on the tendon and allow it to glide more smoothly.
• Tendon repair: This involves stitching together torn or ruptured tendons to restore their function and stability.
• Tendon transfer: This involves moving a healthy tendon from another part of the body to replace a damaged tendon in the wrist.
• Joint fusion: This involves fusing two or more bones together to eliminate movement and pain in the joint. This can provide stability but also limit mobility.
• Joint replacement: This involves replacing damaged parts of the joint with artificial implants made of metal or plastic. This can restore movement and function but also carry risks such as infection or implant failure.

Surgical treatment for wrist tendonitis is usually performed under local or general anesthesia by an orthopedic surgeon or a hand surgeon. The recovery time and outcome may vary depending on the type of surgery and your individual condition.

Wrist tendonitis treatment is a vital step towards alleviating the discomfort and restrictions caused by this common ailment. By seeking medical advice and following your doctor's recommendations, you can get effective treatment for your condition.

Complications and When to See a Doctor

If wrist tendonitis left untreated, it can lead to some complications, such as:

• Decreased range of motion and function of the wrist: The inflammation and swelling of the tendons can limit the movement and flexibility of the wrist. This can make it difficult to perform daily tasks that involve gripping, lifting, or holding objects. It can also affect fine motor skills, such as writing, typing, or playing musical instruments.
• Prolonged and chronic pain: The pain and discomfort in the wrist can persist for a long time and affect your quality of life. The pain may also spread to the hand or forearm or both. Moving the wrist and hand may make the pain worse.
• Recurrence of symptoms: The symptoms of wrist tendonitis may come back if you resume your activities too soon or without proper care. This can cause further damage to the tendons and delay your recovery.
• Tendon weakening or rupture: The inflammation and degeneration of the tendons can make them more prone to tearing or breaking. This can cause severe pain and disability in the wrist and hand. You may need surgery to repair the torn tendons.
• Joint infection: If you have an infection in the tendon sheath, which is a thin layer of tissue that surrounds and lubricates the tendons, it can spread to the joint and cause serious complications. You may experience fever, chills, redness, warmth, and pus in the wrist. You may need antibiotics or surgery to treat the infection.
• Nerve damage: The inflammation and swelling of the tendons can compress or irritate the nerves that run through the wrist. This can cause numbness, tingling, or weakness in the wrist, hand, or fingers. You may also have difficulty feeling or moving your fingers.
• Death of nearby bone: The inflammation and swelling of the tendons can affect the blood supply to the bones near the wrist. This can cause a condition called avascular necrosis, which means death of bone tissue due to lack of blood flow. This can cause pain, stiffness, and deformity in the wrist.

It is important to seek medical advice if you have symptoms of wrist tendonitis that interfere with your daily life and activities. Your doctor can diagnose your condition and recommend the best treatment for you.

Home Remedies and Self-Care

While you should seek medical advice and treatment for your condition, there are also some home remedies and self-care tips that can help you manage and alleviate your symptoms at home. List of tips for home remedies and self-care for wrist tendonitis include:

• Resting your wrist: This is one of the most important home remedies for wrist tendonitis. You should avoid any activities that cause pain or strain on your wrist, such as typing, texting, playing video games, or writing. You should also limit any movements that involve bending or twisting your wrist. You should rest your wrist for several weeks or until your symptoms improve.
• Immobilizing your wrist: You can use a splint or brace to support and stabilize your wrist joint. This can help reduce stress on your tendons and limit movement that may cause pain. You can buy a wrist brace for tendonitis from the Zofore Sport online store. You should wear the splint or brace for several hours a day or as directed by your doctor.
• Applying ice or heat packs to your wrist: This can help reduce pain and swelling in your wrist joint. Ice packs can help numb the pain and reduce inflammation. Heat packs can help relax the muscles and improve blood flow. You can alternate between ice and heat packs for 15 to 20 minutes several times a day. You should always wrap the ice or heat pack in a towel or cloth before applying it to your skin to avoid burns or frostbite.
• Taking over-the-counter pain relievers: You can take anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, to relieve pain and inflammation in your wrist joint. You should take them as directed by your doctor or pharmacist, and only for a short period of time. NSAIDs may have side effects such as stomach irritation, bleeding, or kidney problems. You should not take them if you have allergies, ulcers, liver disease, or other medical conditions that may interact with them.
• Doing gentle exercises: You can do some hand therapy exercises to improve strength and flexibility of your wrist joint. These exercises can also help prevent stiffness and loss of motion in your wrist. You should consult your doctor or physical therapist before starting any exercise program and follow their instructions carefully. Some examples of hand therapy exercises are:
  • Wrist flexion and extension: Hold your arm straight out in front of you with your palm facing down. Slowly bend your wrist up and down as far as you can without pain. Repeat 10 times on each side.
  • Wrist rotation: Hold your arm straight out in front of you with your palm facing down. Slowly rotate your wrist clockwise and counterclockwise as far as you can without pain. Repeat 10 times on each side.
  • Finger spread: Hold your hand in front of you with your fingers together. Slowly spread your fingers apart as far as you can without pain. Hold for 5 seconds and then bring them back together. Repeat 10 times on each hand.
  • Finger curl: Hold your hand in front of you with your fingers straight. Slowly curl your fingers into a fist and then straighten them again. Repeat 10 times on each hand.

By following these tips, you can prevent wrist tendonitis from happening or manage it effectively if it does. However, if you have persistent or severe symptoms of wrist tendonitis that interfere with your daily life and activities, you should consult your doctor for a proper diagnosis and treatment.

References

1. NHS “Tendonitis”
2. Florida Orthopaedic Institute “Wrist Tendonitis”
3. American Academy of Orthopaedic Surgeons (AAOS) “De Quervain's Tenosynovitis”
4. WebMD “What Is Tenosynovitis?”
5. American Society for Surgery of the Hand (ASSH) “Help For Thumb And Wrist Tendonitis”

Related articles:

• Wrist Pain: Causes, Symptoms, Diagnosis & Treatment
• Carpal Tunnel Syndrome: Causes, Symptoms, Diagnosis, and Treatment Options
• Wrist Arthritis: Types, Causes, Symptoms and Treatment
• Ganglion Cyst of the Wrist and Hand: Causes, Symptoms and Treatment
• Wrist Sprains: Causes, Symptoms, Treatment, and Prevention
• Repetitive Strain Injury (RSI): Causes, Symptoms, and Treatment