Tenosynovitis: Symptoms, Causes, Treatment

What are the symptoms of tenosynovitis?

Tenosynovitis is inflammation of the synovial sheath surrounding a tendon. The symptoms of tenosynovitis typically include:

• Pain: Pain along the affected tendon, which may be sharp or aching. The pain can worsen with movement or pressure.
• Swelling: Swelling around the tendon and joint area, which may be visible and can make the area feel puffy or enlarged.
• Tenderness: Tenderness or sensitivity to touch over the inflamed tendon or joint.
• Stiffness: Reduced range of motion and stiffness in the affected joint or tendon, often making it difficult to move or use the limb normally.
• Heat: The affected area may feel warm to the touch, especially if there is significant inflammation.
• Redness: The skin over the inflamed area may appear red or discolored.
• Crepitus: A grating or crackling sensation when moving the affected tendon, caused by inflammation or irritation within the tendon sheath.
• Difficulty with Movement: Problems performing activities that involve the affected tendon, such as gripping, bending, or extending, depending on the location of the tenosynovitis.

Symptoms can vary based on the severity of the inflammation and the specific tendon involved. Common locations for tenosynovitis include the wrists, hands, and feet, and the condition can be caused by repetitive use, injury, or underlying conditions such as rheumatoid arthritis or gout.

What are the causes of tenosynovitis?

Tenosynovitis, inflammation of the synovial sheath surrounding a tendon, can be caused by a variety of factors:

1. Repetitive Strain: Repetitive movements or overuse of a tendon can lead to inflammation. This is common in occupations or activities that involve repetitive gripping, twisting, or heavy lifting.
2. Injury or Trauma: Acute injuries or trauma to the tendon or joint area can cause tenosynovitis. Direct injury or sudden movements that strain the tendon can trigger inflammation.
3. Infection: Bacterial or fungal infections can lead to infectious tenosynovitis. These infections can occur from wounds or cuts that become infected and spread to the tendon sheath.
4. Rheumatic Conditions: Autoimmune diseases like rheumatoid arthritis and gout can cause tenosynovitis. These conditions lead to chronic inflammation that affects the tendons and synovial sheaths.
5. Inflammatory Diseases: Conditions such as psoriatic arthritis or systemic lupus erythematosus (SLE) can cause systemic inflammation that affects the tendons.
6. Poor Biomechanics: Improper technique or poor ergonomics during activities can place excessive stress on tendons, leading to inflammation. For example, incorrect posture or tool use can contribute to tenosynovitis.
7. Aging: As people age, tendons may become less flexible and more prone to inflammation. Age-related changes in tendon structure can make them more susceptible to tenosynovitis.
8. Underlying Health Conditions: Diabetes, obesity, and other metabolic conditions can contribute to an increased risk of tenosynovitis by affecting overall tendon health and inflammation.
9. Repetitive Stress from Sports: Sports activities that involve repetitive motions, such as tennis, golf, or rowing, can cause tenosynovitis, especially if proper techniques are not followed.

Identifying the underlying cause is important for effective treatment and prevention of tenosynovitis. Addressing factors such as overuse, injury, or underlying health conditions can help manage and reduce symptoms.

What is the treatment for tenosynovitis?

Treatment for tenosynovitis focuses on reducing inflammation, relieving pain, and restoring function. The approach typically includes:

1. Rest and Activity Modification: Avoiding activities that exacerbate symptoms is crucial. Resting the affected tendon allows it to heal and reduces inflammation.
2. Ice Therapy: Applying ice to the affected area for 15-20 minutes several times a day can help reduce pain and swelling.
3. Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can help manage pain and inflammation. In some cases, a doctor may prescribe corticosteroids if the inflammation is severe.
4. Compression: Using an elastic bandage or compression wrap can help reduce swelling and support the affected area.
5. Elevation: Elevating the affected limb can help reduce swelling by allowing fluids to drain away from the area.
6. Physical Therapy: A physical therapist can provide exercises to strengthen the muscles around the tendon, improve flexibility, and address any biomechanical issues that may be contributing to the condition.
7. Splints or Braces: Using a splint or brace to immobilize and support the affected tendon can help reduce strain and allow for healing.
8. Heat Therapy: Once the initial inflammation has decreased, applying heat to the affected area can help relax and loosen the tendon and surrounding muscles.
9. Injections: Corticosteroid injections may be used for more severe cases to provide relief from pain and inflammation. This treatment is typically considered if other methods are ineffective.
10. Infection Control: If tenosynovitis is caused by an infection, appropriate antibiotics or antifungal medications will be prescribed to treat the underlying infection.
11. Surgery: In rare cases where conservative treatments are ineffective or if there is significant structural damage, surgical intervention may be necessary to remove inflamed tissue or repair the affected tendon.
12. Ergonomic Adjustments: Making changes to work or activity environments, such as using ergonomic tools or adjusting posture, can help prevent recurrence of tenosynovitis.

Prompt and appropriate treatment is essential to manage symptoms effectively and prevent long-term complications or chronic issues.