The forearm is comprised of two long bones that are called radius and ulna. The wrist in its turn is comprised of the eight smaller bones that connect with the radius and ulna and are known as carpal bones. These bones hold a tube called carpal tunnel which has a nerve and tendons inside and is covered by a ligament. Any tendon of your body can be prone to problems but it is said that the tendons around your wrist are more commonly injured. Wrist tendon pain occurs due to a number of conditions which we are going to discuss here. Let us proceed. Tendons are the soft but and flexible tissue structures that connect our muscles to our bones. While the muscle is fleshy and elastic, the tendons are dense and fibrous.Their purpose is to serve for transmitting the pull of the muscle to the bone and thus cause movement. Some tendons are covered by a protective sheath bearing the name synovium which produces a certain type of fluid that helps keeping the tendons lubricated. If a tendon is injured, the synovium may malfunction.
What are the conditions that cause pain in the wrist tendons and other problems?
Here we are going to take a look at the following conditions:
- Wrist tendonitis, also known as wrist tendinitis or wrist tendinopathy
- De Quervain’s tenosynovitis, also known as de Quervain’s tendinosis or de Quervain syndrome
What is it?
This is a condition which develops due to the overuse of one or more of the wrist tendons or as a result of a traumatic incident. When excessive pressure is put on wrist tendons, either due to by a prolonged or high force (wear and tear or a sudden injury), they may take damage. In wrist tendonitis there is degeneration, fiber thinning and swelling of the tendons but little or no inflammation, despite the name of the condition.
What are its causes?
As we already mentioned, this condition occurs due to either repetitive stress on the tendons or a sudden force. Activities that are said to increase the chance of developing tendonitis are gymnastics, manual work that involves repetitiveness and/or the use of vibrating machines, excessive computer use, sewing etc. The chance gets higher if you suddenly increase the force and/or duration of these activities. Sudden injury to the tendons may be the result of falling onto your outstretched hand or lifting something heavy.
What are the symptoms of wrist tendonitis?
In most of the cases, they develop gradually.
- Pain; with the progression of the tendonitis, daily activities are hindered; pain is felt either upon touching the affected tendons, or during/after activities (sometimes during rest, in the middle of the night or in the morning)
- Ache or stiffness in the wrist and hand after an aggravating activity.
- Swelling around the wrist
- A grating sound or sensation in the tendon
- Numbness, weakness in the hand and fingers, difficulty grabbing things
What are the factors that contribute to the development of wrist tendonitis?
Here are some of the factors that are said to have an impact on whether or not you will eventually develop wrist tendonitis:
- Your muscles are weak/tight
- Your joints are stiff
- You do not give your body the time it needs to properly recover after training or some other activity
- You do not do proper warm-ups before working out
- You have a bad sporting technique which puts too much pressure on your wrist
- Inadequate recovery periods form training or activity
- You have a poor posture when sitting in front of the computer
- You have already hurt your wrist in the past and/or have problems with your neck, back or nerves
Exercises for wrist tendonitis
Your physiotherapist will discuss the exercises that will be the most suitable for your condition. Make sure to consult one before doing anything on your own as there is a chance you may make things worse instead of helping your wrist heal. You will start with exercises that are easier and will eventually switch to more difficult ones, provided there is no increase in symptoms and/or new symptoms. Here are two exercises that your doctor will most likely recommend you do:
- Wrist bends – support your forearm by a table/bench and place your wrist and fingers over the edge of it. After that, bend your wrist forwards and backwards (slowly and carefully). You should not feel any pain and the stretch should be as much as moderate. Do 10 repetitions.
- Wrist rotations – put with your elbow at your side and bent to 90 degrees. After that, rotate your palm up and down (slowly and carefully). You should not feel any pain and the stretch should be as much as moderate. Again, do this 10 times.
De Quervain’s tenosynovitis
What is it?
This condition is characterized by irritation of the tendons on the thumb side of the wrist (around the base of the thumb) and the swelling and/or thickening of their protective sheath which results in friction and pain when performing certain movements with your thumb or wrist.
What are the causes?
Most of the times we are talking about tenosynovitis when there is repetitive overuse of the tendons involved. When you repeat a certain movement every day, this may irritate the sheath around the tendons, thus causing thickening and swelling and difficulty moving your wrist. There are causes other than overuse and these include a wrist or tendon injury and inflammatory conditions such as rheumatoid arthritis.
What are its symptoms?
The symptoms of de Quervain’ tenosynovitis include the following:
- The main symptom is pain – near the base of your thumb, over the thumb side of the wrist. It may spread upwards, may become gradually worse and may be harsher when you try to twist your wrist or hold an object.
- Difficulty moving your thumb and wrist.
- Stiffness; swelling, sometimes accompanied by a cyst.
- A “snapping” sensation when moving the thumb.
What are the risk factors?
This condition is more common in women, especially if they are between the ages of 30 and 50 and/or pregnant. Other risk factors include repetitive lifting for example when you take care of a baby and having a job/hobby that involves excessive wrist motions.
How can it be treated?
As with every condition, starting treatment of de Quervain’s tenosynovitis before it has developed is essential for proper healing. Its goal is to reduce pain and swelling, to keep the thumb moving and ensure no recurrence of the condition. is aimed at reducing inflammation, preserving movement in the thumb and preventing recurrence. Your doctor may prescribe some nonsteroidal anti-inflammatory drugs such as and naproxen and recommend corticosteroid injections into the tendon sheath for swelling reduce. Initial tenosynovitis therapy includes applying ice, immobilization of the thumb and wrist and avoidance of movements that may additionally hurt them. You may find it helpful consulting a physical therapist who can advise you on what exercises to do to avoid irritation of the tendons and strengthen your muscles. In some cases, the condition is more serious and it may require a surgical intervention. It involves opening the sheath that surrounds the tendons to release pressure. After this is done, your tendons can glide freely.
No matter the condition that is responsible for your wrist tendon pain, you should know that immediate proper treatment is of paramount importance. Contact your doctor as soon as you feel that something is not right and he will advise you on what to do next. It is important to avoid repetitive activities as much as you can and make sure that your wrist gets enough rest.