Tendonitis wrist

introduction

Tendon sheaths are found in places in the human body where the tendons are exposed to high levels of stress. They serve as sliding bearings for the tendons and represent a kind of splint for them. The tendons are protected by their tendon sheaths and the friction is reduced by the fluid located in the area between the tendon and the tendon sheath (synovial fluid).

Since the wrist is a very stressed area, tendon sheaths are also found here. There are these on both sides (flexor and extensor side). Here the tendons run from the flexor and extensor muscles of the forearm to the fingers, which control the movements in all directions. Inflammation of the tendon sheaths is called tendovaginitis in technical terms.

Read more at: Tendinitis

causes

Tendonitis usually results from frequent repetitive, monotonous movements. If they occur in the wrist area, they are often caused by working on the computer. But musicians also often suffer from it.

In addition, tendinitis can result from overload. This is particularly the case with sports such as gymnastics, golf or tennis. Even household chores or unfamiliar work can lead to inflammation of the tendon sheaths if the load is appropriate.

Tendonitis is rarely caused by bacterial infections. Here come for example Chlamydia, Gonococci or Mycoplasma possible as a trigger.

Rheumatic diseases such as rheumatoid arthritis can also lead to tendinitis in rheumatism. Therefore, these must also be taken into account in the diagnosis.

Diagnosis

A rheumatic disease can also be one of the causes of tendinitis. If suspected, a blood test should be done.

Most often the diagnosis of Tendinitis of Wrist based on the typical symptoms. Additional palpation and movement tests by the doctor can confirm the diagnosis.

But if a clear diagnosis cannot be made, a Ultrasonic, one Magnetic resonance imaging (MRI) or roentgen Can be used as an imaging technique to make the inflammation visible.

Is there a suspicion of a bacterial infection or a rheumatic Disease as a trigger for tendinitis, so should one Blood test be carried out for clarification.

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Symptoms

Tendonitis in the wrist manifests itself with severe stabbing or pulling pain that is felt with almost every movement in the wrist. In very pronounced stages of the disease, the pain is felt even at rest. In addition to the pain, there is often but not always swelling and / or reddening of the wrist.

In some patients, a grinding or rubbing can be felt and heard when moving the wrist. Pain from passive hyperextension by another person is also a symptom.

In the case of chronic tendinitis, nodular thickening can also be felt on the wrist.

therapy

A bandage is often applied as a therapy.

Patients with tendinitis around the wrist often hold their hand steady on their own to avoid pain. This is also the doctor's approach. This immobilizes the wrist with a bandage or a splint so as not to further irritate the tendon sheaths. In particular, the activity that led to the tendinitis should be avoided. In addition, cold packs help to reduce inflammation. However, these should be wrapped in a cloth beforehand to prevent the skin from freezing.

Pain relievers are used to relieve a patient's pain. These also have an anti-inflammatory effect and can be used either as a tablet or as an ointment. These are mostly ibuprofen or diclophenac.

If the tendinitis is very pronounced and is very painful, the doctor can inject a syringe with cortisone and a local anesthetic to numb the pain directly into the affected area. The cortisone accelerates the resolution of the inflammation.

An antibiotic must be taken if a bacterial infection triggers the inflammation.

If the inflammation persists in spite of all therapeutic approaches, or if it keeps returning, the possibility of an operation should be considered. Here, the tendon sheaths are split, thus preventing increased friction.

For more information, see:

  • Therapy for tendinitis
  • Treatment of tendinitis
  • Forearm bandage

How long does tendinitis on the hand last?

Tendonitis usually lasts a few days and goes away on its own if the joint is spared. The rule here is that the more the joint is spared, the faster the improvement occurs.

However, if tendinitis keeps coming back, it can become chronic. In this chronic stage, it can take a few weeks, sometimes months, to heal.

To prevent this rapid recurrence of the inflammation, it is advisable to take proper follow-up care in the form of physiotherapy. Here the patient learns movement sequences that prevent renewed inflammation.

Complications

Due to the swelling of the tendon sheaths during inflammation, more space is taken up by it than in normal cases. This results in increased pressure on the surrounding structures. The tendons of the flexor muscles of the wrist and the nerve that supplies them (median nerve) pull together through the so-called carpal tunnel to the fingers. If the tendons swell, the nerve is pinched and carpal tunnel syndrome can occur. This typically manifests itself in pain and numbness of the fingers.

prophylaxis

In order to avoid the development of tendinitis of the wrist, one should take care to take regular breaks when performing monotonous activities.

Tendonitis caused by exercise can be prevented by extensive warming up and stretching.

To prevent computer-induced tendinitis of the wrist, a flat keyboard should be used so that the wrists do not have to be bent too much. This can also be achieved with a cushion or cushion in front of the keyboard. An ergonomically shaped mouse helps not to irritate the tendon sheaths too much. In addition, regular breaks with wrist movements help to relieve the tendon sheaths in between.

Illustration of tendinitis on the wrist

Figure tendinitis on the wrist: causes and therapy

Tendinitis
at the wrist -Tendovaginitis

  1. Common tendon sheath (Ssch)
    the finger flexor -
    Vagina communis tendinum
    musculorum flexorum
  2. Transverse carpal band -
    Transverse carpal ligament
  3. Tendon sheaths of the fingers -
    Vaginae synoviales
    digitorum manus
  4. Ssch of the long flexor of the thumb -
    Vagina tendinis musculi
    flexoris pollicis longi
  5. Tendon sheath of
    Extensor carpi ulnaris muscle
    = Elbow-sided hand extensor
  6. Tendon sheath of
    Extensor digiti minimi muscle
    = Little finger extensor
  7. Tendon sheath of
    Extensor digitorum muscle
    = Extensor of the thief
  8. Tendon sheaths of
    Extensores carpi radialis muscles
    longus and brevis

    = Long and short spoke side
    Hand straightener
  9. Tendon sheath of
    Extensor pollicis longus muscle
    = Long thumb extensor
  10. Tendon sheath of
    Extensor pollicis brevis muscle
    = Short thumb extensor
    and Abductor pollicis longus muscle
    = Long thumb spreader
  11. Extensor tendon strap -
    Retinaculum musculorum extensorum
    A - Right palm
    B - Back of the right hand
    I - Possible causes:
    Overload (budget). Work on
    Computers, musicians,
    Sports (gymnastics, golf, tennis).
    from infection with bacteria
    (Chlamydia. Gonococci or
    Mycoplasma)
    II - Therapy:
    Bandage, splint, cooling compresses,
    Pain relievers (tablet, ointment),
    Syringe with cortisone

You can find an overview of all Dr-Gumpert images at: medical illustrations