Hand Tendonitis: What is it? Causes, Symptoms, Diagnosis and Treatment
Hand tendonitis recognizes causes of a different nature; among the latter, in fact, there are: functional overload of the hand, rheumatic diseases such as arthrosis of the hands or rheumatoid arthritis, infections, pregnancy, diabetes mellitus and thyroid diseases.
Hand tendonitis is responsible for local symptoms, which usually include: pain, swelling and a feeling of soreness.
In general, for the diagnosis of tendonitis in the hand, a physical examination and anamnesis are sufficient; however, tests of imaging.
The treatment of hand tendonitis varies according to the triggering cause.
In general, the therapeutic approach adopted in most cases is conservative.
Hand and its Tendons: A Brief Review
The hand is the most distal end of the upper limb of the human body.
Equipped with 5 fingers, the hand has a rather complex structure, which includes: bones, joints, ligaments, muscles and tendons; moreover, it has a fine innervation and a complicated network of blood vessels.
The hand has various functions: it allows you to grasp objects, acts as a tactile sense organ, allows you to communicate and guarantees stability to children, when they are still walking on all fours.
Tendons of the Hand
A tendon is a band of fibrous connective tissue, with a certain flexibility and high in collagen, which joins a skeletal muscle to a bone.
The bones of the hand insert numerous tendons; the latter include: the tendons of the extrinsic extensor muscles of the hand, the tendons of the extrinsic flexor muscles of the hand and the tendons of the intrinsic muscles of the hand (muscles of the thenar eminence, muscles of the hypotenar eminence, lumbrical muscles and interosseous muscles) .
, exactly like enthesopathies, tendinosis and episodes of tendon laceration.
Types of Hand Tendonitis
There are various types of hand tendonitis:
- Tendonitis of the hand with involvement of an extensor tendon. This tendon inflammation affects one or more tendons of the extrinsic extensor muscles of the hand; the extrinsic extensor muscles of the hand are the muscles that allow the extension of the fingers.
The extrinsic extensor muscles of the hand are: the long abductor of the thumb, the short extensor of the thumb, the long extensor of the thumb, the common extensor of the fingers, the extensor proper of the index, the extensor proper of the least finger (or little finger), the short radial extensor of the carpus, the ulnar extensor of the carpus and the long radial extensor of the carpus.
- Hand tendonitis with involvement of a flexor tendon. This tendon inflammation affects one or more tendons of the extrinsic flexor muscles of the hand; the extrinsic flexor muscles of the hand are the muscles that allow the fingers to flex.
The extrinsic flexor muscles of the hand are: the radial flexor of the carpus, the ulnar flexor of the carpus, the long palmar and the eight flexors of the fingers of the hand.
- Tendonitis of the hand with involvement of the synovial sheath of a flexor tendon. An example of stenosing tenosynovitis, this condition is known in slang as trigger finger.
- Tendonitis of the hand with involvement of the synovial sheath of the abductor longus tendons of the thumb and short extensor of the thumb. Sometimes described as a particular case of wrist tendonitis, this stenosing tenosynovitis of the hand is also known as De Quervain syndrome and De Quervain stenosing tenosynovitis.
Deepening: what is the Stenosing Tenosynovitis
The synovial sheath of the tendons is the singular membrane that surrounds the tendons themselves, in order to facilitate their sliding with respect to the surrounding anatomical structures; without the synovial sheath, the tendons would rub against their surroundings, which would cause irritation and impair their functioning.
By stenosing tenosynovitis, doctors mean the inflammation of the synovial sheath of a tendon, followed by the narrowing of the sheath itself and the inability of the tendon contained in it to slide, as usual, without friction of any kind.rheumatoid, arthrosis of the hands, gout or systemic lupus erythematosus;
Who suffers most from Hand Tendinitis?
Hand tendonitis can affect anyone; however, statistics in hand, this annoying form of tendon inflammation is more frequent among:
- Those who practice sports in which the use of the hands is foreseen to grab, push or throw objects with force (eg: weight lifting), and sports in which the continuous twisting of the wrist is expected (eg: golf);
- Those who are employed in jobs that rely on the constant use of the hands in function of activities such as hammering, typing on a keyboard, moving the PC mouse, etc.
Hand Tendonitis: Risk Factors
Risk factors for hand tendonitis include:
- The practice of sports in which it is expected to grab, push or throw objects with force, and sports in which the continuous twisting of the wrist is expected;
- The practice of manual work;
- Intensive use of the PC mouse or smartphone;
- Suffering from a rheumatic disease, such as rheumatoid arthritis, arthrosis of the hands, gout or lupus;
- Suffering from diabetes mellitus or some thyroid disease
- The pregnancy;
- The female sex;
- Improper use of corticosteroids (leads to weakening of the tendons).
During the physical examination which is used to identify hand tendonitis, the doctor palpates the hand and, sometimes, the patient's wrist at points significant to the diagnosis; moreover, he asks the patient to carry out specific movements with the suffering hand and sometimes also with the wrist which, in case of tendonitis in the hand, would evoke pain (the presence of pain when performing these movements is, therefore, a alarm bell).
In the physical examination phase, two tests useful for the diagnosis of De Quervain syndrome are the so-called Finkelstein test and the so-called Eichhoff test.
In the path leading to the diagnosis of tendonitis in the hand, the anamnesis allows us to establish the causes and factors that favored the onset of inflammation.
Knowledge of the causes and risk factors of hand tendonitis is important when planning therapy.
Hand Tendonitis: Surgery
Surgical treatment of hand tendonitis varies depending on the condition that is supporting the inflammation.
Generally speaking, surgery for hand tendonitis involves interventions aimed at repairing / cleaning the suffering tendon (s), which, due to prolonged inflammation, may have suffered damage.
Hand tendonitis: how to prevent it from getting worse?
In general, to prevent the worsening of hand tendonitis, it is essential to immediately stop any activity that evokes pain, even if the latter is bearable or controllable with an NSAID.