The wrist consists of small joints that connect the hand to the rest of the body and for the movement of the hand.
The movement of the upper limb or arms is important for our ancestors and for the people of today. The wrist has played a crucial role in the functioning of the arms, primarily the distal part, the hand. The ability to move the hand in space is vital for our advanced and precise hand function. Without the wrist, it’s impossible to move the fingers and the hand.
The wrist area contains not only bones and muscles. It also contains ligaments and tendons. The ligaments connect one bone to another and tendons connect the muscles to the bones. When the tendons in the area become irritated and inflamed, it can lead to a condition called wrist tendonitis.
Wrist tendonitis, also called tenosynovitis, is a common condition marked by the irritation and inflammation of the tendons surrounding the wrist joint. Many tendons surround the wrist area, and the condition usually affects one of these tendons. In some cases, it can be two or more.
2Signs and symptoms
The most common and consistent symptoms most people with wrist tendonitis experience is a pain in the wrist.
The other signs and symptoms include:
- Swelling around the wrist joint
- Warmth and redness of the tendons
- Crepitus or grinding sensations with tendon movement
Although tendonitis can be caused by a sudden trauma, blow or injury, the condition is more likely to root from repeated movements over time. Most individuals develop tendinitis because their jobs and hobbies involve these repetitive motions, which place stress and tension on the tendons.
Wrist tendonitis is an overuse condition that happens due to repetitive friction or strain of the tendon. This happens in a tendon that rubs over the bony prominence of the bone. It could also stem from the repetitive strain placed on the tendon. This is different from the wrist pain caused by the injury to a ligament, which is responsible for connecting bone to other bones. Tendons, on the other hand, connect muscles to the bones.
The activities that require repetitive movements are most likely the culprits to the development of wrist tendonitis. Some of the sports activities like tennis and badminton may cause his injury. Wrist tendonitis is also common in people who are working in factories, production lines, and computers.
There are certain factors that may increase one’s risk of developing wrist tendonitis, which includes:
Age – As people get older, the tendons become less flexible, leading to the development of various injuries.
Sports – Certain sports may increase the risk of having wrist tendonitis. These sports usually involve repetitive motions, particularly if the athlete’s movement and technique are improper or aren’t optimal. The sports activities include baseball, bowling, basketball, swimming, golf, tennis, running and badminton.
Incorrect posture at work or home – Incorrect posture at work or at home may also lead to wrist tendonitis, particularly if you do not practice proper body mechanics.
Arthritis and other conditions – People with these conditions may have a higher risk of having wrist tendonitis and tendonitis of the other parts of the body. The conditions include rheumatoid arthritis, psoriatic arthritis, gout, medical reactions and thyroid problems.
Poor stretching or conditioning before working out – Before working out, exercise or a sports activity, you will get wrist tendonitis if you do not properly stretch or condition the muscles and tendons.
Work – Some occupations are at a higher risk of developing wrist tendonitis. These jobs involve awkward positions, repetitive movements, overhead reaching, vibration and forceful exertion.
Tendon rupture – If the condition is left untreated, it can increase the risk of having tendon rupture, a serious condition that may need surgery.
Tendinosis – Also, if wrist tendonitis is not treated immediately, it might lead to tendinosis may develop, a condition where degenerative changes in the tendon happen, with abnormal new blood vessel growth.
The doctor will conduct a thorough physical assessment of the entire arm, which includes the elbow, shoulders, wrist, and hand. Also, a medical history interview will be conducted to determine the activities that could have contributed to the condition.
During the physical examination, the doctor will check the range of motion and strength in the entire upper arm. Moreover, he will touch and palpate areas of the wrist and forearm to determine which tendons are affected and if there is inflammation in the area.
Some doctors may require blood tests to look for the causes of the inflammation around the joint, such as gout or rheumatoid arthritis.
In some cases, the doctor may also require X-rays to confirm that there is no fracture or dislocations. Moreover, ultrasound or magnetic resonance imaging (MRI) scan may be needed to detect tendon damage and the extent of the damage.
Since the condition causes inflammation, pain, and tenderness, it may get better with rest. However, in some cases, treatment may be needed. The treatment for wrist tendonitis is similar to another tendonitis in other parts of the body.
The common treatment options include:
Rest and splints – Many soft tissue problems are caused by the overuse of the muscle. The initial treatment is to rest the affected area and avoiding doing some activities for the meantime. The use of splints, slings, and braces are effective in helping the area rest as the pain eases.
Medicines – Over-the-counter medicines may be recommended for pain and inflammation. Usually, non-steroidal anti-inflammatory (NSAID) medicines are recommended because they target both pain and swelling.
Corticosteroids – The doctor may also resort to corticosteroid injections around a tendon to relieve elbow tendonitis. The injections reduce inflammation and can help ease the pain.
Warm and cold compress – The cold compress can help reduce the swelling and pain when the injury happened. It is effective in the first 48 hours after overuse, swelling or injury. After which, a warm compress is ideal for long-term or chronic pain.
Physical therapy – The doctor may recommend that you enroll in a physical therapy program of specific exercise. This exercise is designed to strengthen and stretch the affected muscle-tendon unit.
Platelet-rich plasma – Platelet-rich plasma (PRP) involves taking a sample of the blood of the patient to separate the platelets and other healing factors. The plasma is then injected into the affected area.
Surgery – When all else fails, the doctor may recommend surgery depending on the severity of the condition.
Ultrasonic treatment – Ultrasonic treatment is minimally-invasive wherein a small incision is made to insert a device that can remove the scar tissue in the tendon through the use of ultrasonic sound waves.
Dry needling – Dry needling is a procedure wherein small holes are made in the tendon with the use of a needle to stimulate the healing factors to act on the injured or damaged tendon.
Lifestyle changes and home remedies
For home remedies, you should remember the acronym RICE, which means rest, ice, compression and elevation to reduce pain and inflammation.
Rest – As soon as you felt pain during activity, you should rest. Also, avoid activities that can increase pain and swelling. It is the key to tissue healing and a faster recovery.
Ice – As soon as injury or pain happens, you can reduce pain by applying ice to the affected area for up to 20 minutes many times a day. Do not apply the ice pack directly to the skin. Use a thin washcloth or towel before applying it.
Compression – Since swelling may lead to reduced motion, compress the area until the swelling has ceased. Elastic bandages can be used.
Elevation – Elevate the affected area, if it’s located in the lower part of the body.
To prevent and reduce the risk of developing wrist tendonitis, here are the preventive measures:
- Avoid activities that put extra stress and pressure on the tendons, particularly the hand and wrist area.
- Improve your technique in sports activities to make sure there will be no tendon problems.
- Observe proper body mechanics when lifting, throwing, or working.
- Stretch before working out or any sports activities
- Use proper workplace ergonomics
- Warm up before starting strenuous exercise
- Perform the intensity of the workout gradually
- Avoid activities that require prolonged periods of reaching over the head and lifting heavy objects.
- Use wrist splints or braces to promote faster healing.
- For people performing racket sports, change the racket with a larger head to prevent re-injury.
- Avoid repetitive wrist and hand movements
- Perform regular stretching of the wrist, forearm, and hand to maintain flexibility before and after exercise or activity.
- Do regular upper-body-strengthening exercises to make sure the wrist and hand can tolerate activities of daily living and sports with less stress and pressure on the joint and tendon.
- Do not continue an activity that is painful or uncomfortable to the hand and wrist.
- Follow joint protection techniques and measures when using the wrist like resting from work, applying braces and using the larger muscles in the arms for a heavier workload, such as lifting, pushing and pulling.