Tenosynovitis is a condition that involves the inflammation of the tendon sheath, which is the protective covering that surrounds a tendon. This condition can cause significant pain and restrict movement, impacting daily activities and quality of life.
What is Tenosynovitis?
Tendons are fibrous cords that connect muscles to bones, allowing for movement of the joints. Surrounding these tendons are tendon sheaths, which are filled with a lubricating fluid that helps reduce friction as the tendon moves. Tenosynovitis occurs when the tendon sheath becomes inflamed, often causing pain, swelling, and difficulty moving the affected joint.
Symptoms of Tenosynovitis
The symptoms of tenosynovitis can vary depending on the location and severity of the inflammation. Common symptoms include:
- Localised Pain – Sharp or aching pain along the tendon and surrounding area, especially with movement.
- Pain with Activity – Discomfort that increases with movement or use of the affected tendon.
- Visible Swelling – Swelling along the tendon or around the joint.
- Tenderness – The area may be tender to the touch.
- Limited Movement – Stiffness in the affected joint, making it difficult to move the tendon smoothly.
- Inflammation Signs – The skin over the affected tendon may appear red and feel warm to the touch.
- Grinding Sensation – A feeling of grinding or creaking when the tendon is moved.
Causes and Risk Factors
Several factors can lead to tenosynovitis, including repetitive motion, injury, and underlying health conditions. Common causes and risk factors include:
- Occupational Hazards – Jobs that involve repetitive motions, such as typing, assembly line work, or using hand tools.
- Sports – Activities that involve repetitive movements, such as running, climbing, or racket sports.
- Trauma – Direct injury to the tendon or surrounding area can cause inflammation.
- Bacterial Infections – In rare cases, a bacterial infection can lead to tenosynovitis, especially if there is a cut or puncture wound near the tendon.
- Rheumatoid Arthritis – Autoimmune conditions like rheumatoid arthritis can cause inflammation of the tendon sheaths.
- Diabetes – Individuals with diabetes are at a higher risk of developing tenosynovitis.
- Ageing Tendons – Tendons lose elasticity and strength with age, making them more susceptible to inflammation.
Common Types of Tenosynovitis
Tenosynovitis can affect any tendon sheath, but some areas are more commonly affected:
De Quervain’s Tenosynovitis
- Location – Affects the tendons on the thumb side of the wrist.
- Symptoms – Pain and swelling near the base of the thumb, difficulty grasping or pinching.
Trigger Finger (Stenosing Tenosynovitis)
- Location – Affects the tendons in the fingers or thumb.
- Symptoms – Finger or thumb catches or locks when bent, then snaps straight.
Flexor Tenosynovitis
- Location – Affects the tendons in the fingers, particularly in the palm.
- Symptoms – Pain, swelling, and difficulty bending the affected finger.
Diagnosis
If you experience persistent pain or swelling in a tendon, it’s important to see a healthcare provider for a proper diagnosis. Diagnosing tenosynovitis typically involves:
Medical History
- Symptom Inquiry – Your doctor will ask about your symptoms, activities, and any recent injuries or infections.
Physical Examination
- Joint Movement – Examining the affected area for tenderness, swelling, and range of motion.
- Palpation – Feeling the tendon for any crepitus or nodules.
Imaging Tests
- Ultrasound – To visualise the tendon and tendon sheath, confirming inflammation.
- MRI – Provides detailed images of soft tissues to rule out other conditions.
Laboratory Tests
- Blood Tests – To check for markers of infection or autoimmune conditions.
- Fluid Analysis – In cases of suspected infection, fluid from the tendon sheath may be analysed.
Treatment Options
The goal of tenosynovitis treatment is to relieve pain and reduce inflammation. Treatment options include:
Rest
- Activity Modification – Avoid activities that aggravate the symptoms and allow the tendon to heal.
Ice and Heat
- Cold Packs – Apply ice packs to the affected area for 15-20 minutes several times a day to reduce swelling.
- Heat Therapy – Use heat packs to relax muscles and improve blood flow after the initial inflammation subsides.
Medications
- Pain Relievers – Over-the-counter medications like ibuprofen or naproxen can help reduce pain and inflammation.
- Corticosteroids – Injections of corticosteroid medications can provide temporary relief of inflammation and pain.
Physical Therapy
- Exercises – A physical therapist can design a program of specific exercises to strengthen the muscles around the tendon and improve flexibility.
- Manual Therapy – Techniques such as massage and stretching to reduce tension in the tendon.
Braces or Supports
- Immobilisation – Using braces, straps, or supports to limit movement and reduce stress on the tendon.
Surgery
- Severe Cases – In rare cases, if tenosynovitis does not respond to other treatments, surgery may be required to release the tendon sheath and relieve pressure.
Managing and Preventing Tenosynovitis
Preventing tenosynovitis involves making changes to reduce the strain on your tendons. Here are some tips:
- Use correct techniques and body mechanics in sports, exercise, and daily activities.
- Gradually increase the intensity and duration of your physical activities to avoid overloading your tendons.
- Engage in regular exercises that strengthen and stretch the muscles around the tendons to improve flexibility and reduce the risk of injury.
- Ensure that your workstation is set up ergonomically to avoid awkward positions and repetitive strain.
- Wear shoes that provide adequate support and cushioning, especially if you are involved in sports or spend a lot of time on your feet.
- Always warm up before exercising and cool down afterwards to prepare your muscles and tendons for activity.
Tenosynovitis is a common condition that can cause significant pain and discomfort, but with the right knowledge and management strategies, you can effectively manage and prevent it. If you suspect you have tenosynovitis, it’s important to seek medical advice early to manage symptoms and prevent further injury. By staying active, using proper techniques, and taking care of your body, you can reduce your risk of tenosynovitis and maintain a healthy, active lifestyle.
