Three common tendon afflictions are tenosynovitis, tenovaginitis, and tendinosis. When the synovial lining around a tendon becomes inflamed, this is known as tenosynovitis. When a tight covering or sheath constricts the tendon, this is called tenovaginitis. When the tendon becomes diseased or degenerated from age, poor blood supply, friction, or over-use, this is known as tendinosis.
Trigger Finger
Trigger Finger is a tenosynovitis of the tendons that cause the fingers and thumb to flex into the palm. It is common in patients with diabetes. It is caused when the tendon can no longer smoothly glide through the sheath which surrounds it, which causes painful “clicking” as the tendon passes through. Eventually the finger can become “locked” as the tendon is no longer able to pass through the sheath. Patients initially complain of pain over the palm. They may need to use their other hand to pull the finger straight. Treatment starts with rest and steroid injections. Splinting with the fingers straight can avoid triggering and prevent tendon irritation. Surgery is required for persistent symptoms, and involves a release of the surrounding sheath. Surgery is commonly performed under local anesthesia in an outpatient setting, and has a short recovery period. Patients are encouraged to use their hands as soon as possible after surgery to prevent stiffness.
DeQuervain’s Tendonitis
DeQuervain’s Tendonitis involves the tendons that cause the thumb to extend away from the rest of the hand. It is caused by repetitive tasks involving the thumb and the wrist. It is often seen in the post-partum period in women. Pain is located over the thumb side of the wrist. Evaluation by a hand surgeon is important to differentiate this condition from arthritis, fractures, and nerve conditions. The initial treatment includes rest, anti-inflammatory medications, stretching exercises, and steroid injections. A thumb splint may provide relief as resting the tendons allows the irritation to heal. Surgery is needed when these measures don’t relieve the pain. It’s performed under local anesthesia in an outpatient setting.
Tennis Elbow
Tennis Elbow is formally called lateral epicondylitis. It is caused by degeneration and microtears of a muscle (the extensor carpi radialis brevis) where it originates from the outside part of the elbow. Activities that require wrist extension such as tennis backhand and hammering are associated with this condition. Pain is caused by forceful wrist extension, and is worse when the elbow is straightened. Evaluation by a hand surgeon is helpful in differentiating this condition from elbow arthritis or nerve problems. 90% of patients with this condition get better with non-operative treatment, which involves rest, hand therapy, and bracing. Steroid injections are also helpful. Golfer’s Elbow, formally called medial epicondylitis, is less common than tennis elbow. It is pain on the inside part of the elbow caused by irritation of the muscles which flex and rotate the wrist. Treatment is similar to Tennis Elbow.
At Advanced Specialty Care, we provide a full range of hand treatments including tendonitis. Our sophisticated hand surgeons treat such maladies as carpal tunnel syndrome, Dupuytren’s contractures, nerve injuries and osteoarthritis, as well as many unsightly conditions like ganglions, arthritic spurs, protruding veins and skin blemishes. We are located in Danbury, in Fairfield County, Connecticut.