Hand Tendonitis: What is it? Causes, Symptoms, Diagnosis and Treatment

alla mano is the expression that generically defines any inflammation affecting the tendons of the hand or their synovial sheaths.

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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

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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;
  • Infections in which the responsible pathogen has reached one of the tendons of the hand. Among the pathogens that most commonly cause hand tendonitis are bacteria such as: Staphylococcus aureus, Pasteurella multocida, Eikenella corrodens And Mycobacterium marinum;
  • Pregnancy in women. In this regard, experts believe that the hormonal changes characteristic of gestation are responsible for the inflammatory process.
  • Diabetes or thyroid disease. Diabetes and thyroid disease are extremely different conditions, but they have in common that they are harmful to the tendons.
  • Who suffers most from Hand Tendinitis?

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    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).
    muscle-tendon. It allows to analyze the state of health of the inflamed tendon (s);
  • MRI. Allows an accurate view of every musculoskeletal component of the hand, including tendons;
  • X-rays. They are used when the diagnostician suspects a bone fracture or a condition such as arthrosis of the hands or rheumatoid arthritis.
  • Physical examination

    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).

    Curiosity

    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.

    Anamnesis

    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.

    per day on the painful area, for 15-20 minutes each (shorter or longer applications are ineffective);
  • The intake of a non-steroidal anti-inflammatory drug (NSAID) or paracetamol. The use of these drugs is indicated to calm the inflammatory state and painful symptoms;
  • The use of a hand brace. To be worn overnight, the hand braces accelerate the healing process;
  • Stretching exercises for stretching the hand muscles.
  • Recalling that it is impossible to heal from "arthrosis in the hands and from" rheumatoid arthritis, hand tendonitis due to the two aforementioned conditions involves symptomatic therapy based on: functional rest of the hand, application of ice on the painful area, taking an NSAID or a corticosteroid (if the NSAID is ineffective), use of a night brace for the hand, physiotherapy exercises to stretch the muscles of the hand and, finally, the application of capsaicin cream on the painful hand.
  • Episodes of tendonitis in the hand due to bacterial infections require antibiotic treatment in order to eliminate the responsible pathogen from the organism.
  • Cases of hand tendonitis sustained by diabetes mellitus or thyroid disease require therapy aimed at managing the aforementioned conditions.
  • Hand tendonitis resulting from pregnancy heals spontaneously after childbirth; while waiting, functional rest of the hand and the application of ice on the painful area are indicated; on the other hand, drugs should be avoided, unless otherwise indicated by the treating physician and gynecologist.
  • 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.

    and the variation of training.

    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.

    Antonio Griguolo

    Graduated in Biomolecular and Cellular Sciences, he obtained a Specialized Master in Journalism and Institutional Communication of Science
    Tags:  eye-health diagnosis-diseases toxicity-and-toxicology