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Tenosynovitis
Tenosynovitis
Tenosynovitis is a type of tendon injury. A tendon is a strong tissue that attaches a muscle to a bone. Some tendons are covered by a sheath which makes a tiny amount of lubricating fluid which surrounds the tendon. The fluid helps the tendon to move smoothly when it pulls on the bone it is attached to. Tenosynovitis is inflammation of the tendon sheath, and it commonly occurs around the wrist.
How do we treat tenosynovitis at the Mansfield Clinic?
First of all the precise diagnosis has to be made. This can be quite tricky, and this is where expertise in examination and diagnosis is important, and Dr Allfree has a lot of experience in diagnosis and treatment of such problems.
Treatment of established cases of tenosynovitis will usually involve rest, manual therapy such as osteopathy, carefully constructed exercise regimes, and sometimes localised steroid injections, depending on the location of your tendinosynovitis.
In cases that do not respond to simple treatments, surgery may need to be considered, although this is rare. Dr Allfree will be able to arrange the appropriate referral.
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What causes tenosynovitis?
Tenosynovitis typically occurs when the tendons are overused. This may be due to playing a lot of sport, or doing a lot of DIY. Lots of writing, typing, or assembly line work, can trigger an episode of tenosynovitis. This type of overuse injury is often called Repetitive Strain Injury (RSI).
In some cases, there is no history of overuse of the tendon, and tenosynovitis seems to occur for no apparent reason.
Who gets tenosynovitis?
This problem is more common in middle-aged adults, particularly people who engage in sport. It may be more common if your work involves repetitive movements such as writing, typing or use of a computer mouse.
What are the symptoms of tenosynovitis?
The main symptoms are pain, tenderness and sometimes swelling of the affected part of the tendon sheath. The pain is aggravated by moving the affected area. The overlying skin may also feel warm. There may also be stiffness and reduced movement of the wrist or the fingers that are operated by the affected tendon.
Tenosynovitis can last weeks or months if it is not effectively treated.
One relatively common form of tenosynovitis at the wrist is called De Quervain's tenosynovitis. This affects the tendons that are used to straighten the thumb. The typical symptom is pain over the wrist at the base of the thumb, aggravated by activity and eased by rest.
Do I need any tests?
Dr Allfree will normally be able to make the diagnosis of tenosynovitis simply by talking to you and examining the affected area. Sometimes, if the diagnosis is uncertain, he may suggest an MRI scan of the affected area.
What is the treatment?
One or more of the following treatments may be used:
- Rest. It is important to rest to allow the condition to settle. Sometimes a splint is put on a wrist. This enforces your hand and wrist to stay in the same position for a time to allow rest of the affected tendon.
- Ice packs over the affected area may ease swelling and pain. Purpose made ice packs are available from the Mansfield Clinic.
- Anti-inflammatory painkillers such as ibuprofen are often prescribed to ease pain and reduce inflammation.
- Manual therapy such as osteopathy may be advised.
- A steroid injection into the affected area may be given if the above measures do not work.
- If the above measures do not work, then surgical release of a tendon may be needed, although this is rare.