Patient education: Tenosynovitis (The Basics)

What is tenosynovitis? — 

This is when a tendon and the covering around it get inflamed. Tendons are strong bands of tissue that connect muscles to bones.

Tenosynovitis happens most often in the hand or wrist. There is a special type of tenosynovitis that can affect the finger, called "trigger finger." Tenosynovitis can also happen in other parts of the body, such as the ankle.

Different things can cause tenosynovitis, such as:

●Overuse – This means using the hand or wrist too much, or doing the same hand or wrist motion over and over.

●Inflammatory arthritis – These are types of arthritis that can lead to joint pain and inflammation. Examples include rheumatoid arthritis, spondyloarthritis, and gout.

●Infection – Tenosynovitis that is caused by an infection can lead to serious problems. The infection can spread to and damage nearby tissues and muscles.

Sometimes, tenosynovitis happens for no known reason.

What are the symptoms of tenosynovitis? — 

Symptoms can include:

●Pain when moving a joint

●Swelling of tendons or around joints

●Trouble grabbing or gripping objects (if your hand is involved)

●Trouble walking (if your ankle is involved)

Will I need tests? — 

Maybe. Your doctor or nurse will ask about your symptoms and do an exam. They will examine your hand and fingers carefully and see how they move and work.

Your doctor or nurse might do tests, depending on your symptoms and what's causing your tenosynovitis. Different tests can include:

●An imaging test such as an X-ray, ultrasound, or MRI scan – These create pictures of the inside of the body.

●Blood tests

●Tests on a sample of fluid – If you have an infection and a collection of pus around your tendon, the doctor will use a needle to remove some pus. Then, they will send the sample to a lab for tests.

How is tenosynovitis treated? — 

Treatment depends on what's causing your tenosynovitis and your symptoms.

Tenosynovitis caused by overuse is treated with 1 or more of the following:

●Rest – Rest the painful area, and avoid using it or putting a lot of pressure on it. If tenosynovitis is in your hand, your doctor might recommend you wear a brace or splint, or use "buddy taping." Buddy taping is when you tape a finger to the finger next to it (figure 1). If you have severe tenosynovitis in your ankle, your doctor might suggest using an adaptive device such as crutches for some time.

●Ice – You can put a cold gel pack, bag of ice, or bag of frozen vegetables on the area every 4 to 6 hours, for 15 minutes each time. Put a thin towel between the ice (or other cold object) and your skin.

●Medicines called "NSAIDs" – These medicines relieve pain and reduce inflammation. Examples include ibuprofen (sample brand names: Advil, Motrin) and naproxen (sample brand name: Aleve).

●Stretches – After your symptoms improve, your doctor or nurse will show you stretches to help your joints move more easily. They might also refer you to a physical therapist (exercise expert).

For tenosynovitis that is caused by a type of arthritis, treating the arthritis can help improve symptoms.

Tenosynovitis that is caused by an infection is treated with:

●Surgery – The doctor drains the pus, washes out the area around the tendon, and cuts away any dead tissue.

●Antibiotic medicines

If your symptoms do not get better or come back, your doctor might recommend other treatments depending on the cause. These can include:

●Getting a shot of a steroid medicine – These help reduce inflammation.

●Surgery to cut or loosen the covering around the tendon – This is only an option for some people with certain types of tenosynovitis (for example, people with trigger finger who do not get better with other treatments).

Can tenosynovitis be prevented? — 

Maybe. If your symptoms are from overusing the affected joint or repeating the same movement:

●It might help to take breaks when doing these movements.

●Do gentle stretching before and after these movements.

●If a joint feels tired or hurts, stop the activity and rest. Do not ignore or try to work through pain.

When should I call the doctor? — 

Call your doctor or nurse if:

●You have any signs of an infection, including:

•A fever of 100.4°F (38°C) or higher, or chills

•The affected area looking red or swollen

●The pain spreads to other areas.

●You have numbness or tingling in the affected area.

●Your symptoms do not get better or get worse.

More on this topic

Patient education: Hand pain (The Basics)
Patient education: Common finger injuries (The Basics)
Patient education: de Quervain tendinopathy (The Basics)
Patient education: Rheumatoid arthritis (The Basics)
Patient education: Gout (The Basics)
Patient education: Nonsteroidal antiinflammatory drugs (NSAIDs) (The Basics)

Patient education: Arthritis (Beyond the Basics)
Patient education: Gout (Beyond the Basics)
Patient education: Nonsteroidal antiinflammatory drugs (NSAIDs) (Beyond the Basics)