DefinitionTendons 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 sleeve. It occurs most often in the hand, wrist, or foot.
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CausesMost cases of tenosynovitis are caused by one of the following:
- Repetitive motions such as those used for:
- Computer operation
- Assembly line work
- Cash register operation
- Sports that involve repetitive actions
- Playing musical instruments
Risk FactorsFactors 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
SymptomsTenosynovitis may cause:
- Joint pain
- Joint stiffness
- Joint swelling
- Difficulty moving a joint
- Redness along the length of the tendon
DiagnosisYou 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. Your doctor will use this to look for signs of bacterial infection or other conditions such as rheumatoid arthritis. Your doctor may refer you to a hand specialist.
TreatmentTalk 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:
RestResting the involved joint is often the best treatment for tenosynovitis. A brace or splint may be used to help you rest the joint. Rest may be combined with basic stretching and strengthening exercises.
Physical TherapyYour doctor may refer you to a physical therapist. Therapy will help to reduce discomfort and promote recovery through exercise. The therapist may also suggest modifications to your workplace to reduce stress to the area.
Ice and HeatApplying ice or heat to the area may decrease pain and swelling. Start with ice, especially soon after the injury. If ice is not helpful, try heat.
MedicationsSeveral medications are used to treat tenosynovitis. These include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) to help reduce inflammation and pain
- Topical pain medicines, such as creams and patches, that are applied to the skin
- Corticosteroids—injected into the sheath
- Antibiotics—if tenosynovitis was caused by a bacterial infection
SurgerySurgery may be used for severe tenosynovitis. The surgery will release the tendon and allow it to move freely.
PreventionTo 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
American Academy of Orthopaedic Surgeons
American Society for Surgery of the Hand
Canadian Orthopaedic Foundation
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 February 28, 2014.
De Quervain tendonitis. American Academy of Orthopedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00007. Updated December 2013. Accessed February 28, 2014.
De Quervain’s tenosynovitis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated July 10, 2013. Accessed February 28, 2014.
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.
- Reviewer: Teresa Briedwell, PT, DPT
- Review Date: 02/2014
- Update Date: 02/28/2014