Hand and wrist tendonitis: prevention and treatment

What is tendonitis?

Tendonitis is defined as tendon-specific pain and inflammation. Your tendon is like a thick cord attaching muscle to bone. When this is inflamed, in your hand and wrist for example, your daily activities, including sports and work, can be affected. It’s important not to confuse tendonitis with tendinopathy. The symptoms may be similar, but the causes are very different. Tendinopathy is the result of a degeneration of the collagen protein that makes up your tendon, whereas tendonitis is the inflammation of your tendon.

What causes tendonitis to flare up?

Tendonitis often occurs due to overuse through frequent similar movements. The following are risk factors which can make you more prone to developing hand and wrist tendonitis:

• Being assigned female at birth
• If you’re aged over 40
• If you have a job which involves repetitive hand or wrist motions, such as using heavy machinery, a hairstylist, or desk work where you’re typing all day. You can be even more prone to developing tendonitis if you don’t have the correct arm, wrist or hand position when you’re carrying out your role
• Playing sports such as gymnastics, tennis or basketball that put a lot of strain on your hand and wrist, or not conditioning your wrists properly before beginning a new activity
• If you have certain health conditions like osteoarthritis, rheumatoid arthritis or diabetes
• Having a history of tendon injuries
• Smoking and having an infection can also make you more at risk of tendon inflammation

New parents and childcare providers who lift and hold babies for multiple hours each day are especially prone to a very common condition called De Quervain’s tenosynovitis. This condition, often called “mother’s wrist” means you’ll experience pain with thumb abduction (moving your thumb away from the hand), grasping items and wrist movements away from the thumb.

What does tendonitis feel like in your hand or wrist?

The symptoms of tendonitis are often worse when you’re moving your joint. You’ll experience a pain in your tendon that intensifies when in use, difficulty moving your hand and wrist, feeling a grating or crackling sensation when you move your tendon and swelling which is sometimes accompanied by heat or redness.

What is the difference between carpal tunnel syndrome and tendonitis?

Carpal tunnel syndrome is caused by nerve compression and tendonitis is the result of inflammation. The key difference between these two conditions is where the pain is located.

With carpal tunnel syndrome, the pain is located on the palm side of your wrist. Symptoms include tingling and numbness which may then spread to the wrist, thumb, or fingers (mainly the thumb, index finger and middle finger).

With wrist tendonitis, the pain is located on the other side of your wrist. The pain extends into the little finger, increases with movement and a lump or bump may appear around your tendon.

How can tendonitis in your hand or wrist be prevented?

Every day activity

Avoid activities that place too much stress on your hands and wrist tendons, especially for long periods of time. If you have pain during an exercise, stop and attempt to gently complete the exercise the following day.

In the workplace

We know that avoiding activities which involve using your hands and wrists can’t be achieved if this is a big part of your job - for example if you work at a computer or in a trade.

In your workplace, make sure any chairs, desks or keyboards you are using are positioned correctly for your height, arm length and the tasks you do. This will help protect your joints and tendons from stress

After work, move your joints through their full range of motion. The best time to stretch is after movement, when your muscles are warmed up. Rotating your wrists and stretching out your fingers to increase your flexibility may help.

If you suspect your work environment may be causing your hand and wrists discomfort, carry out a Display Screen Equipment (DSE) assessment which will be available from your workplace

When playing sports

When exercising or playing sports, make sure you mix up your activity if it’s causing pain. Ensuring you are doing specific exercises correctly will help to prevent damaging your hand and wrist tendons. Consider taking lessons or getting professional instructions when starting a new sport or using exercise equipment

How is tendonitis of the hand or wrist treated?

At Benenden Hospital, we offer our patients a three-step Physiotherapy programme to help you on your recovery journey.

Step one: explain what tendonitis is and aim to reduce your acute pain

This can be achieved through avoiding further irritation by changing your movements or actions that create pain and/or by using a splint temporarily to prevent movement within the painful range of motion.

A splint must be considered a temporary solution to pain-free movement and should not be relied upon or considered a cure for your injury. At our hospital, we believe our patients must be treated fully to ensure they regain correct function rather than relying on a splint which reduces mobility.

You will also begin isotonic exercise, which means your muscle movements take place with normal contractions and little straining.

This will be accompanied by taking non-steroid anti-inflammatory drugs (NSAIDs) such as Ibuprofen or Naproxen.

Step two: continue using isotonic exercise to strengthen your joint

At this stage, finding the correct weight to lift is essential, as too much will cause further irritation and swelling, and too little won’t have an overloading effect on the muscle. We look to stress the muscle and tendon enough to strengthen your muscle.

Step three: functional rehab is aimed at returning you to your usual activities

Prior to this stage, pain must have been controlled and decreased by improving the strength of your hand and wrist. Workers should repeat the following exercises:

• Practice typing on the keyboard
• Hand flexion exercises with a towel
• Rolling a tennis ball under a hand to simulate a mouse
• Finger/thumb opposition exercises to increase hand mobility

Is surgery required for tendonitis treatment?

We offer patients who are suffering from tendonitis three to six months of physiotherapy. Throughout this treatment, you will be continually assessed and your need for surgical intervention discussed.

It is rare for a patient to require surgical intervention to relieve tendonitis, but in the event this is required, we do offer tendon operations, such as a tenosynovectomy. These procedures are designed to treat inflammation of the tendon.

You may have some pain or discomfort after the operation, which we’ll help you manage with painkillers. We’ll tell you how to care for your wound and, if you’ve had non-dissolvable stitches, we’ll make an appointment for you to have them removed.

A programme of physiotherapy will usually be suggested to help speed up recovery. You may need some time off work, depending on the exact nature of your surgery.

How long does it take for tendonitis to heal in the hand and wrist?

Relief from your tendonitis symptoms in your hand and/or wrist can be noticed after three to six months of treatment. This can vary from person to person, but if there are signs of healing progress and your goals are being achieved, your health professional will continue with your current treatment.

Our Physiotherapists will assess you to see if your activities have become easier and less painful. If this is the case, we tell our patients to build upon the time spent doing these activities and how strenuous they are until you have returned to your full work capability before tendonitis developed.

The final step for your recovery is to prevent future issues with your tendon. This can be achieved by continuing with rehabilitation exercises and continuing to move your muscles and tendons through the various activities provided to you by your Physiotherapist.

Access our private treatments and services

If you’re struggling with pain, stiffness and reduced mobility in your hand and wrist, you could have tendonitis. Get back to work and your daily activities by booking an appointment with our Private GPs or Physiotherapists.

Published on 30 March 2023