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Tenosynovitis(Synovitis)

Pronounced: ten-o-sin-o-VITE-is

Definition

Tendons are the cords that connect bones to muscles in the body. They are covered by a sleeve-like tissue. Tenosynovitis is an inflammation of this tissue. It occurs most often in the hand, wrist, or foot.

Tenosynovitis

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Causes

Most cases of tenosynovitis are caused by one of the following:

  • Injury
  • Infection
  • Strain
  • Repetitive motions such as those used for:
    • Computer operation
    • Assembly line work
    • Cash register operation
    • Sports that involve repetitive actions
    • Sewing
    • Playing musical instruments
Risk Factors

Factors that may increase your risk of tenosynovitis include:

  • Repetitive actions with your hand, wrist, or foot during work or play
  • Diseases that cause inflammation such as gout and rheumatoid arthritis
Symptoms

Tenosynovitis may cause:

  • Joint pain, stiffness, or swelling
  • Difficulty moving a joint
  • Redness along the length of the tendon

Tenosynovitis is common in the tendons of the thumb. This is called de Quervain’s tenosynovitis. It causes pain and stiffness in the thumb side of the wrist.

The wrists, hands, and feet are also commonly affected. Tenosynovitis that affects tendons of the fingers can also make the finger stick in a bent position.

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. It will include an assessment of the joint.

A blood test may also be done. It will be done to look for signs of bacterial infection or other conditions such as rheumatoid arthritis. You may be referred to a hand specialist.

Treatment

Talk with your doctor about the best treatment plan for you. The goal of treatment is to reduce swelling and pain and to allow the tendon to move freely. Treatment options include the following:

Supportive Care

The tendon will need time to heal. Supportive care may include the following: . A brace or splint may be used to help you rest the joint. Rest may be combined with basic stretching and strengthening exercises.

  • Activities may need to be restricted. Normal activities will be gradually reintroduced.
  • Ice therapy may help decrease pain and swelling. If ice is not helpful, heat therapy may be advised.
  • A brace or splint may be used to help rest the joint.
Physical Therapy

A physical therapist will assess the tendon. An exercise program will be created to reduce discomfort and promote recovery. The therapist may also suggest modifications to your workplace to reduce stress to the area.

Medications

Several medications are used to treat tenosynovitis. These include:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) to help reduce inflammation and pain
  • Topical pain medications, such as creams and patches, that are applied to the skin
  • Corticosteroid injections to reduce swelling
  • Antibiotics to treat infection
Surgery

Surgery may be used for severe tenosynovitis. The surgery will release the tendon and allow it to move freely.

Prevention

To prevent tenosynovitis, avoid overuse of your tendons. Take the following steps if you have a job or hobby that involves repetitive motions of the hand, wrist, or foot:

  • Adjust your workspace to minimize the strain on your joints.
  • Alternate activities when possible.
  • Take breaks throughout the day.
  • Exercise regularly.

RESOURCES:

American Society for Surgery of the Hand
http://www.assh.org

OrthoInfo—American Academy of Orthopaedic Surgeons
http://orthoinfo.aaos.org

CANADIAN RESOURCES:

Canadian Orthopaedic Foundation
http://www.canorth.org

Health Canada
http://www.hc-sc.gc.ca

References:

de Quervain syndrome. American Society for Surgery of the Hand website. Available at: http://www.assh.org/Public/HandConditions/Pages/deQuervainsTendonitis.aspx. Published 2012. Accessed March 10, 2015.

De Quervain tendonitis. American Academy of Orthopedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00007. Updated December 2013. Accessed March 10, 2015.

De Quervain’s tenosynovitis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated January 20, 2015. Accessed March 10, 2015.

10/26/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Massey T, Derry S, Moore R, McQuay H. Topical NSAIDs for acute pain in adults. Cochrane Database Syst Rev. 2010;(6):CD007402.



Last reviewed March 2015 by Teresa Briedwell, PT, DPT

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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