Tenosynovitis is an inflammation of the tenosynovium, a sheath that covers tendons. Tendons are the cords that connect bones to muscles in the body. Tenosynovitis can occur in any tendon with a synovial sheath. However, it most often occurs in the hand, wrist, or foot. Usually this condition can easily be treated; contact your doctor if you think you may have tenosynovitis.
Most cases of tenosynovitis are caused by one of the following:
- Computer operation
- Assembly line work
- Cash register operation
- Sports that involve repetitive actions
- Playing musical instruments
If you perform repetitive actions with your hand, wrist, or foot for work or play, you may be at an increased risk of developing tenosynovitis. Diseases such as gout]]> and ]]>rheumatoid arthritis]]> can contribute to the swelling of tendon sheaths.
The infections that cause some cases of tenosynovitis occur more often in people with the following conditions:
- IV drug abuse
- Compromised immune systems
If you experience any of these symptoms, do not assume it is due to tenosynovitis. These symptoms may be caused by other conditions. If you experience any one of them, see your physician. Symptoms of tenosynovitis include:
Your doctor will ask about your symptoms and medical history, and perform a physical exam. The physical exam may include:
- Asking you to move the affected joint
- Feeling the joint and along the involved tendon
A blood test may also be performed to look for signs of bacterial infection or other conditions such as rheumatoid arthritis. For certain types of tenosynovitis, your doctor may refer you to a hand specialist.
Talk with your doctor about the best treatment plan for you. The goals of treatment for tenosynovitis are to reduce swelling and pain and to allow the tendon to move freely through the tendon sheath. Treatment options include the following:
Stopping movement in the joint, sometimes with the help of a brace or splint, is often the best treatment for tenosynovitis. Rest may be combined with stretching and strengthening exercises for the muscles attached to the tendon.
Several medications are used to treat tenosynovitis. These include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) to help reduce inflammation and pain:
- Corticosteroids, given as an injection into the tenosynovium, a thin tissue that covers the tendons
- Antibiotics, if your doctor finds that your tenosynovitis was caused by an infection
For severe cases of tenosynovitis, surgery may be used to release the tendon and allow it to move freely within its sheath.
The most important action you can take to prevent tenosynovitis is to avoid overuse of your tendons. If you have a job or hobby that involves repetitive motions of the hand, wrist, or foot, you can take the following steps:
- 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
US Department of Labor Computer Workstation E-tool
Association for Repetitive Motion Syndromes (ARMS)
Canadian Centre for Occupational Health and Safety (CCOHS)
De Quervain tendonitis. American Society for Surgery of the Hand website. Available at: http://www.assh.org/Content/NavigationMenu/Patients_and_Public/deQuervains_Tendinitis/deQuervains_Tendinitis.htm . Accessed September 1, 2005.
Medical encyclopedia: tenosynovitis. MedlinePlus, US National Library of Medicine and the National Institutes of Health website. Available at: http://nlm.nih.gov/medlineplus/ency/article/001242.htm . Accessed September 1, 2005.
Trigger finger. MayoClinic.com website. Available at: http://www.mayoclinic.com/invoke.cfm?id=DS00155 . Accessed September 1, 2005.
Last reviewed November 2008 by ]]>John C. Keel, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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