Download Tendonitis, De Quervain`s Tenovaginitis, Trigger Finger, Golfer`s

Tendonitis / Tenosynovitis
What is it?
Inflammation and swelling of tendons or the tendon lining or sheath.
Symptoms
Pain and swelling and sometimes a grating sensation along the line of the
affected tendon, aggravated by use.
What causes it?
Anything that causes the area to swell or inflame, such as an injury, overuse
or some medical conditions such as inflammatory arthritis. There is not always
a clear cause.
Treatment
Rest – avoid using the affected tendon to allow the inflammation to settle
Pain relief - Anti-inflammatory tablets, or gels that can be applied to the
affected area (e.g. Ibuprofen tablets or gel) can help reduce inflammation
Splints – worn day and night for a few weeks to immobilise and rest the
affected tendons and settle the inflammation.
Steroid injection – If the above measures fail, steroid (a powerful antiinflammatory) can be injected around the affected tendon.
Surgery – If all else fails, day-case surgery may be advised to release the
tendon and relieve pain.
Will it come back?
Tendonitis can recur. A change of the pattern of use of the hand may be
required to reduce the risk of recurrence – e.g. alteration of workstation setup. Even surgery does not completely guarantee permanent relief of
symptoms. This should be discussed with your surgeon.
De Quervain’s Tenovaginitis
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(1 dorsal compartment tendonitis, washer-woman’s wrist)
What is it?
This is one of the commonest forms of tenosynovitis (see above)
and affects the thumb tendons where they run along the side of the
wrist
Symptoms
Pain and swelling at the base of the thumb which can spread up
the thumb or into the forearm. Worse with use and movement of the thumb.
Commonly seen in new mothers after repeated use of the hand to lift babies
Treatment
See tendonitis treatment above.
Surgery to release the tendons is a minor procedure performed as a daycase under local anaesthetic.
Trigger Finger
What is it?
A finger that ‘triggers’ or clicks and may lock – usually
in a bent position
Symptoms
The affected finger or thumb clicks on movement, or may temporarily lock in a
bent or straight position, sometimes requiring use of the other hand to release
it. Pain may occur over the top of the first knuckle in the finger, or in the palm.
What causes it?
Thickening (inflammation) of the tendon or tendon sheath restricts gliding of
the tendon. When the tendon catches in its sheath, this is felt as a clicking.
Treatment
Pain relief – anti-inflammatory medication or gel
Splint – may be required for 4-6 weeks to resolve symptoms
Steroid Injection – may cure problem with 1-3 injections into tendon sheath
Surgery – If other methods fail, surgery involves a small incision in the palm
to release the tendon sheath. Minor daycase surgery under local anaesthetic.
Will it come back?
Recurrence is possible but rare after surgery.
Golfers / Tennis Elbow
(Medial / lateral epicondylitis)
What is it?
Inflammation / tear of the origin of the flexor muscles at the
inner aspect of the elbow (golfers) or extensor muscles at the outer aspect of
the elbow (tennis).
Symptoms
Pain felt at the inner or outer aspect of the elbow when gripping objects or
using the hand. The elbow may be tender to touch.
What causes it?
Repetitive use or a minor injury may cause inflammation of the origin of the
muscles where they are attached to bone at the elbow.
Treatment
Rest – avoidance of repetitive action. May resolve over time (can take years)
Pain relief – anti-inflammatory medication or topical gels
Splint – a strap around the forearm may help by reducing muscle tension
Steroid injection – can give excellent pain relief but symptoms may return.
Surgery –release of the inflamed muscle under day-case general anaesthetic
Will it come back?
Recurrence is common, but less likely following surgery