Wrist Tendinitis is an inflammation of one or more wrist tendons. It is a common inflammation in people who perform major tasks using their arms. Examples of these people are athletes who use their hands to throw and catch balls, factory employees, and older people due to the lack of elasticity in the tendons in the wrist.
Wrist tendinitis is caused by micro-tears that occur from repetitive or sudden injury in a tendon. The common symptoms of this inflammation are stiffness, swelling, and pain in the wrist. Please contact our physicians at Suarez Physical Therapy who are experienced in handling wrist tendinitis and can offer various procedures to ease your pain.
Overview of Wrist Tendinitis
The wrist has various tendons that attach the forearm and hand muscle to the wrist and hand bones. Tendons appear like small ropes that join the back of your hand and your fingers.
Here are a few types of tendons:
- Tendons that engage in wrist flexion are involved explicitly in rotating the wrist and bending it inward and forward.
- Tendons used in finger motion move from the muscle belly in the forearm to the finger/thumb bones.
- Tendons used in wrist extension enable the wrist to bend backward and move towards the little finger or the thumb.
These tendons can be affected by conditions like:
- Wrist tendinitis — This name is given to the condition when it is in its early stages.
- Tenosynovitis — When the synovial sheath becomes thick and restricts the tendon, the condition is referred to as tenosynovitis.
- Tendinopathy — applies when the inflammation persists over time without being treated and becomes chronic.
- De Quervain’s — This is the name given to the tendinitis that grows on the thumb.
In this article, we will focus on wrist tendinitis.
Types of Wrist Tendinitis
Wrist tendinitis is categorized depending on the type of tendon affected. They include:
- Flexion Wrist tendinitis — an inflammation that is caused by bending the wrist forward repeatedly. (Eg. Flexor carpi radialis)
- Extension Wrist tendinitis — an inflammation that occurs from bending the wrist backward repeatedly. (e.g. intersection syndrome, and Extensor carpi ulnaris tendinitis)
Most of these injuries are experienced from sports like rowing, rock climbing, and golf.
Reasons Why Wrist Tendons are Prone to Tendinitis
Apart from load-bearing activities, housework, and sports, several other factors put wrist, forearm, and hand tendons and muscles at risk for injury. They include:
- Heat —Tendons are more likely to experience increased internal temperature due to their repetitive use during activities. The increase in temperature puts the tendons of the wrist at risk of getting damaged.
- Blood Vessels — Muscles have more blood supply than tendons. When the muscles are contracted for long, for instance, while working, tendons may experience a shortage in blood supply. If the wrist tendon experiences a deficiency in blood supply for long, it may suffer long-term damage.
- Nerves — Wrist tendons are smaller in size, and they engage in fine movements with more nerve endings and nerve fiber which are at risk of injury compared to the large tendons.
You should seek immediate medical help if you experience the following symptoms:
- If you are unable to move the wrist
- If you experience persistent and severe swelling on the wrist
- If your forearm, hand, or wrist experiences severe and sudden pain and swelling
- If your forearm, hand, or fingers become numb or tingly.
In most cases, the above symptoms indicate a severe medical condition like nerve injuries or bone fractures in the wrist, and it is crucial to seek immediate medical help.
Symptoms Associated with Wrist Tendinitis
Different people experience different wrist tendinitis symptoms depending on how severe their injury is. The most common symptoms include:
- Swelling — if the tendon becomes inflamed, the tissues surrounding it swell and cause the wrist to swell. If your hand or forearm is also swollen, it is an indication that you have an inflamed or injured muscle around it.
- Pain — If you experience a constant dull ache, a sharp pain, or a burning sensation, you could be suffering from wrist tendinitis. At times you may feel pain on the fingers or up in the elbow. If you are hit on the injured tendon, you may also experience pain.
- Unable to bear weight — If you have an inflamed or injured tendon, you may find it hard to bear some weight on the wrist. You are likely to experience pain if you engage in weight-bearing activities.
- Reduced strength — You are likely to feel weak around the wrist while engaging in physical activity if you have an injured tendon. You may also experience pain if you Force the weak wrist to do some physical work, and if you were already in pain, it might persist.
- Stiffness — If you have an affected tendon on the wrist, you may experience some stiffness that may reduce the wrist’s movement.
- Warmth and Bruising — Bruising is caused by the tearing of small blood vessels, which makes your skin turn black, blue, or red on the affected part. You may also feel some warmth due to the flow of blood on the affected wrist.
- Snapping, popping, or tearing — you may experience a feeling of tear, which occurs when tendons rub against the muscles. You may also experience some snapping or popping sensation.
- Cramping and Muscle fatigue — If the injury extends to the nearby muscles, you may experience some muscle cramps as well as fatigue.
Some wrist tendinitis symptoms are less common, but some people still experience them. They include:
- Anxiety and depression — This is common for people who experience severe and persistent wrist tendon pain. The incapability of tolerating pain may lead to depression. If you are also afraid to engage in any physical activity because of pain, the fear may result in anxiety.
- Pain at rest — If the wrist tendinitis is severe, you may experience wrist pain even when resting.
- Loss of motion — If the wrist infection leads to calcium deposition around the tendons, you may experience wrist calcific tendinitis, making the wrist painful and stiff.
- Numbness — If the inflamed tendon irritates the nearby nerve, your fingers may feel numb.
Risk factors Related to Wrist Tendinitis
Just like any other injury, some people have a greater risk of developing this inflammation on their wrist than others. Some causes of wrist tendinitis can be prevented since they are lifestyle related while others are genetics and hard to prevent.
Here are some of the factors that may lead to the development of this condition:
- Medication — Medicine like corticosteroids may lower the healing chances of the tendon and make the tendon structure weak if taken regularly increasing the chances of developing wrist tendinitis on the users.
- Repetitive movements — People who engage in regular housework and sport like golf are at a higher risk of developing wrist tendinitis due to repetitive wrist movements.
- Genetic disorders — Wrist tendinitis has been linked with genetic disorders like hypermobility and Ehlers-Danlos at large.
- Metabolic disorder — Some metabolic disorders have also been linked to wrist tendinitis like obesity, diabetes, and high cholesterol.
- Age — as a person ages, the tendons also experience changes like inconsistent tissue formation, and the tendons lose almost half of their ability to bear weight.
It is essential to seek medical help if you suspect wrist tendinitis and have any of the risk factors listed above.
What are the Major Causes of Wrist Tendinitis?
There are two significant causes of wrist tendinitis, which include:
- Repetitive Injury — This type of injury usually results from daily activities and playing sports. The symptoms include stiffness and pain in the wrist that develop with time and may become severe as the injury worsens.
- Acute Injury — This type of injury results from playing sports, car accidents, or falls, and sometimes a tendon may also tear. For acute injuries, the symptoms of wrist tendinitis, which include pain and swelling develop with time as the injury worsens.
If wrist tendinitis is left untreated, it may result in a chronic inflammation known as tendinosis.
How is Wrist Tendinitis Diagnosed?
Experienced hand surgeons and physicians can be able to diagnose wrist tendinitis. Here are different ways which physicians use to diagnose this condition.
The first step the physician will conduct is to evaluate your medical history. They will do this by asking questions about:
- When you started experiencing the symptoms like pain
- The type and nature of the pain
- Whether you are experiencing decreased hand strength
- Whether you have experienced any injury or trauma near the wrist
- Whether there are any cramps or spasms on the hand
This is also among the first steps, and the physician looks out for:
- Any bruising or swelling on the hand or wrist
- The range of motion and flexibility of the wrist
- Tenderness, they apply pressure on the wrist gently
The physician may also carry out some clinical tests as clinical examination.
Physicians use clinical tests to check the stability of the tendon on the wrist and check the severity of the tendinitis. They are also able to locate the exact position of the wrist tendinitis. These clinical tests include:
- Wrist flexion tests — There are two main tests under these categories, and they are all used to check inflammation on the flexor tendons. They include:
- FCU (Test for flexor Carpi Ulnaris) tendon — Here is what happens during this test:
- The physician places your forearm on a table with your palm on top.
- They bend the wrist towards the small finger.
- They apply resistance on the wrist, and you are supposed to hold the wrist up during this time.
- FCR (Test for flexor carpi radialis tendon — Here is what happens during this test:
- The physician places your forearm on the table with the palm facing up.
- The physician bends the wrist up.
- They apply resistance as you hold the wrist up, and if you experience any pain, it indicates an inflamed tendon.
- Wrist extension tests — The physician performs two primary tests to check if the extensor tendons are inflamed. They are:
- ECU (extensor carpi ulnaris tendinitis test) — Here is how the procedure is carried out:
- The physician put your forearm on the table with your palm facing down
- You are asked to bend your wrist backward while making a fist, and as the physician supports the forearm
- While in that position, the physician pushes the small finger out of the fist and towards the thumb and if you experience pain, it shows that there is an inflamed tendon.
- ECRB (Extensor carpi radialis brevis tendons test and ECRL (Extensor carpi radialis longus test — Here is how the procedure is carried out:
- The physician places your forearm on the table with your elbow bent at 90 degrees and your palm facing down
- You are asked to make a fist and have your wrist bend backward while the physician is supporting your forearm.
- The physician then gently applies force at the back of your hand to provide resistance.
- Finkelstein’s test — During this procedure, you are supposed to make a fist and ensure that the other fingers cover your thumb. Then bend your wrist towards the small finger, and if you feel any pain, it means that you have an inflamed tendon.
At times, the physician may ask you to go for an imaging test to confirm the inflammation of the tendons.
Wrist Tendinitis Imaging Test
Here are some of the most common imaging tests used to evaluate tendon injuries:
- MRI — If the physician wants to check the tendons’ condition and the surrounding cartilage and bones, he will ask you to undergo a wrist MRI.
- An ultrasound — This imaging is used to check the injured tendon and the condition of the soft tissues surrounding the tendon.
Can Wrist tendinitis be Treated Without Surgery?
There are a few nonsurgical treatments for inflamed tendons. If the tendinitis is not severe, you should heal within a few weeks. Here are some of the most common non-surgical treatments for injured/inflamed tendons:
Exercising is one of the most recommended nonsurgical treatments for wrist tendinitis. However, there are a few factors that you should consider while using the exercise technique. They include:
- Using loads — It is always advisable to use a lighter load and repeatedly exercise than use a heavier load and exercise a few times.
- Eccentric exercise — These exercises cause muscle tension that is crucial for healing the tendon. They limit inflammation by stimulating the production of collagen leading to less heat production in the tendon.
It is important to always follow guidance from your physical therapist when exercising to heal the tendon.
After suffering wrist tendinitis, it is crucial to get enough rest. Here are a few ways you can ensure that your wrist gets enough rest:
- Avoid any irritating activity
- Use slings around the wrist
Note that for the tendon fiber to heal, you need to move the tendon, so ensure you use the wrist irregularly to perform minor tasks.
The (platelet-rich plasma) is concentrated blood gotten from the patient’s body and is back into the body. The PRP is known to promote the healing and growth of soft tissues like the tendon. One injection may be enough if the tendons are not severely injured.
ESWT (Extracorporeal Shock Wave Therapy)
In this procedure, the therapist uses a hand device to administer shock waves to the inflamed tendons. This procedure aims to ease pain by hindering the growth of new nerve tissues in the inflamed tendon.
How to Avoid Pain Caused by Wrist Tendinitis
There are a few self-care practices that can help you ease the pain of an inflamed tendon. They include:
- Applying cold packs on the affected area- You may use cold packs with intervals of maybe 3 hours to reduce pain and inflammation
- Use softer force — Pinch activities can apply less force on tendons
- Use both hands — using both hands to carry out an activity will divide the strain into more tendons
Surgery for Wrist Tendinitis
There are very few cases where surgery is used to treat wrist tendinitis. Here are some of the instances that the physician can recommend surgery as a treatment method:
- The tendinitis has failed to respond to the non-surgical treatment and has developed into tendinosis.
- You still experience pain and other severe symptoms even after trying the nonsurgical measure for over three months.
- The tendon injury is severe and puts the tendon at risk of tearing further.
To avoid wrist tendinitis symptoms from becoming chronic, it is essential to seek help once you suspect an inflamed tendon.
Find a Las Vegas Physical Therapist
If you have suffered wrist tendinitis, it is essential to seek medical attention from an experienced physician to ease pain and prevent the symptoms from worsening. Our physicians at Suarez Physical Therapy are certified in handling wrist injuries. Whether your injury is sport- or work-related, we offer a tone of different procedures to offer you the relief you need. If you are in Las Vegas, NV, reach out to us today at 702-368-6778, and we will gladly create a customized treatment plan for you.