Tenosynovitis - Symptoms, Diagnosis & Treatment

  • Tenosynovitis refers to the inflammation of the protective sheath surrounding the tendon
  • Tendonitis refers to the inflammation of the tendon itself

TenosynovitisThese two conditions are sometimes confused and may occur at the same time.

Tendons are strong bands of flexible cord made from a fibrous collagen tissue which attaches muscle to bone – bound to the muscle at one end and to the bone at the other end. Much like ligaments, which join one bone to another, tendons are exceptionally strong, helping to move the bones and joints when the muscles contract.

Tendons are covered by a protective sheath – this comprises of two membranes, the outer being the fibrous tendon sheath and the inner the synovial sheath which is found where the tendon passes under ligaments and through osseofibrous tunnels, reducing friction and allowing the tendon to move freely.

Symptoms

Tenosynovitis may occur at any tendon, however tendons in the wrist and the hand are more commonly however affected. When there is a problem with the tendon or the sheath, movement may be restricted and in the case of the thumb or finger, making it difficult to bend– this is often accompanied by pain and swelling and in some instances there is an audible crack.

Stenosing Tenosynovitis (Trigger Finger)

Inflammation of the tendon sheath in one or more of the tendons in the hand causes pain and stiffness at the base of the finger or thumb making it difficult to bend or straighten the affected finger – this can make everyday tasks such as writing or typing extremely difficult. In some cases, the affected tendon locks into place, when it unlocks, it may spring back suddenly rather like a trigger releasing on a gun – hence the name trigger finger.

De Quervain’s Tenosynovitis

A form of tenosynovitis affecting the tendons at the base of the thumb and the side of the wrist, inflammation of the affected area causes painful symptoms and may result in difficulty moving the thumb.

Tennis Elbow Syndrome

Painful symptoms usually appear on the outside of the elbow caused by inflammation in the tenons of the forearm. The condition may be worsened during repetitive movements, such as sports or writing.

Causes

Injury or Strain

A pre-existing injury or strain may make it more easy to develop tenosynovitis, leading to inflammation.

Repetitive Strain Injury (RSI)

RSI is a blanket term used to describe pain felt in either muscles, tendons or ligaments caused by a repetitive movement. Tenosynovitis can be associated with overuse of the tendon during repetitive movements, such as sports or writing, typing etc.

Rheumatoid Arthritis

Tenosynovitis can develop secondary to rheumatoid arthritis – an autoimmune condition causing pain, swelling and stiffness in the joints.

Gender

Women particularly in their 40s and 50s tend to suffer more from this condition than men.

Diabetes

Often associated with tenosynovitis.

Bacterial Infection

In some cases a bacterial infection may cause inflammation – it may be the result of a cut or puncture wound which allows bacteria to travel to the nearest tendon. In a small number of people it may be a complication of gonorrhoea, a sexually transmitted infection. A bacterial infection may be accompanied by painful symptoms, redness and fever and skin abnormalities around the affected area.

Treatment

Medication

Over the counter analgesics and anti-inflammatories may provide effective pain relief. Stronger pain medication may also be prescribed by your physician.

Physiotherapy

A physiotherapist may devise a specific exercise plan to help relieve the painful symptoms.

Steroid Injection

Cortisone may be injected at the site to reduce the inflammation of the muscles, tendons and joints.

Splinting

Resting the tendon in question helps to allow the inflammation to settle – this can be achieved by splinting or bracing which reduces movement.

Surgery

Depending on the exact type of tenosynovitis, surgery may be an option.

Pain Management

Any type of chronic pain can seriously affect the patient’s quality of life, as simple everyday tasks may become a struggle. A pain management consultant works closely with a multi-disciplinary team of physiotherapists, psychologists, surgeons and other health professionals in order to devise a comprehensive treatment plan.

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